Functional constipation in children: What physicians should know

Tran, Duc Long; Sintusek, Palittiya

doi:10.3748/wjg.v29.i8.1261

Cited by 20 publications

(15 citation statements)

References 153 publications

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“…However, the authors included studies that considered different FC diagnostic criteria, varying from self-report to the Rome II and III criteria [ 11 ]. Similar global percentage of FC (14.4%) was found evaluating only studies conducted using the most recent Rome IV criteria [ 12 ]. To confirm this, Russo and colleagues in 2019 found no statistically significant difference comparing the prevalence of FC according to the Rome III and Rome IV criteria (17.3% vs. 18.2% p = 0.8) [ 13 ].…”

Section: What Is the Incidence?supporting

confidence: 73%

The ten “hard” questions in pediatric functional constipation

Fedele,

Fioretti,

Scarpato

et al. 2024

Ital J Pediatr

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Functional constipation is a common problem in childhood and has a great impact on social, physical, and emotional functioning of affected children and their caregivers. No organic cause of the constipation can be found in approximately 95% of children, defining the “so-called” chronic functional constipation. Its prevalence has been reported to range from 0.7 to 29.6%, with a median of 12%. The diagnosis of functional constipation is exclusively clinical based on the pediatric diagnostic Rome criteria for functional gastrointestinal disorders and does not routinely require laboratory and/or radiological investigations. In case of alarm signs and symptoms that may suggest organic diseases, further investigations can be required. The therapeutic management is based on non-pharmacological and pharmacological approaches. Education, demystification of constipation and reward-based toilet training represent the cornerstones of nonpharmacological management. Disimpaction, maintenance treatment and weaning of medication are all elements of pharmacological treatment. Osmotic laxatives, mainly polyethylene glycol (PEG), are considered the first-choice laxative for both disimpaction and maintenance treatment. The aim of this review is to provide pediatric gastroenterologists with a practical tool to support the clinical and therapeutic management of children and adolescents affected by chronic functional constipation.

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Section: What Is the Incidence?supporting

confidence: 73%

The ten “hard” questions in pediatric functional constipation

Fedele,

Fioretti,

Scarpato

et al. 2024

Ital J Pediatr

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“…The Rome Foundation first defined childhood FC in the Rome III criteria in 2006, and the Rome III diagnostic criteria for FC in children were updated by the Rome IV criteria in 2016 ( Drossman, 2016 ). Notably, although there were some changes in diagnostic criteria for FC in Rome IV, the prevalence of FC in children was similar whether Rome IV or Rome III criteria were used ( Tran and Sintusek, 2023 ). The pathophysiologic mechanisms of FC in children are generally recognized as complex and multifactorial, including disturbed gut microbiota, anorectal dysfunctions, stool withholding behavior, psychological issues, genetic predisposition, and diet ( Levy et al., 2017 ).…”

Section: Discussionmentioning

confidence: 99%

“…Incorrect bowel training, defecation in a standing position, and painful defecation with hard stools all tend to promote fecal retention in the rectum and lead to hard fecal clumps. The prevalence of fecal soiling, palpable fecal mass on abdominal examination, and withholding behavior in children with FC have been reported to be 33%-77%, 33%-68%, and 37%-91%, respectively ( Tran and Sintusek, 2023 ). Therefore, oral laxatives and organized toilet training are the mainstays of treatment for FC in children ( Tran and Sintusek, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of fecal soiling, palpable fecal mass on abdominal examination, and withholding behavior in children with FC have been reported to be 33%-77%, 33%-68%, and 37%-91%, respectively ( Tran and Sintusek, 2023 ). Therefore, oral laxatives and organized toilet training are the mainstays of treatment for FC in children ( Tran and Sintusek, 2023 ). In addition, the role of the gut microbiome in the pathophysiology of FC is increasingly being emphasized.…”

Section: Discussionmentioning

confidence: 99%

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Probiotics for functional constipation in children: an overview of overlapping systematic reviews

Zhang,

Li,

Qiu

et al. 2024

Front. Cell. Infect. Microbiol.

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BackgroundThis overview of systematic reviews (SRs) and meta-analysis (MAs) aimed to systematically collate, appraise and synthesize evidence of probiotics for functional constipation (FC) in children.MethodsSRs/MAs of probiotics for FC in children were systematic identified by searching Cochrane Library, PubMed, Embase, and Web of science. Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) were unitized by two reviewers independently to assess the methodological quality, reporting quality, and quality of evidence, respectively.ResultsSeven SRs/MAs met the eligibility criteria and were included in this study. According to AMSTAR-2, a very low methodological quality assessment was given to the included SRs/MAs due to the limitations of items 2, 4 and 7. For the PRISMA statement, the overall quality of reporting was unsatisfactory due to the lack of reporting on protocol, risk of bias across studies, synthesis of results, and additional analysis. According to GRADE, the quality of evidence for outcomes was rated as very low to moderate.ConclusionsProbiotics may be beneficial in improving FC in children. Because of limitations and inconsistent conclusions, further rigorous, normative and comprehensive SRs/MAs are needed to provide robust evidence for definitive conclusions.

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“…Функціональні закрепи посідають вагоме місце в структурі функціональних розладів травного тракту, їхня частота сягає 14,4% [23], причому втричі частіше вони відмічаються в дітей раннього віку. Нерідко симптоми з'являються впродовж першого року життя, коли відбуваються значні зміни в харчуванні немовляти, зокрема, введення продуктів прикорму та раннє переривання грудного вигодовування [11,16].…”

Section: Methodsunclassified

Improving an integrated approach to the treatment of functional constipation in children

Krycky,

Hoshchynskyi,

Shulhai

et al. 2023

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Functional constipation in children has become a serious medical issue that needs to be addressed immediately. They can significantly limit children’s physical activity and social integration, which emphasizes the importance of providing them with effective care. Purpose - to analyze and improve the results of the complex use of a lactulose-based drug and prophylactic phytocylinders with a lipophilic complex of rose hips and chamomile extract in the treatment of functional constipation in children. Materials and methods. We examined 78 children with constipation over the past 3 years. They were divided into two groups. The first group included 36 (46.2%) patients, the second - 42 (53.8%). Patients of the first group received standard treatment according to the protocols of the Ministry of Health of Ukraine, patients of the second group received similar treatment and additionally lactulose in the form of syrup and a preparation based on prophylactic phytocylinders with a lipophilic complex of rose hips and chamomile extract during the course of treatment daily in the form of rectal suppositories. Results. Most patients were female (60.2%), had average physical development parameters. The duration of constipation ranged from 1 to 3 months, and stool retention - from 3 to 5 days. At the beginning of the observation, there were complaints of changes in the shape and consistency of stools, painful defecation, flatulence, periodic abdominal pain, strong straining during defecation, fear or anxiety in children before the act of defecation. An analysis of anamnestic data showed that in one third of patients, constipation was observed during the transition from breastfeeding to artificial feeding. Conclusions. The analysis of the addition to the complex of treatment of functional constipation, in addition to lactulose, of preparations based on prophylactic phytocylinders with a lipophilic complex of rose hips and chamomile extract is a safe and quite effective method of correcting these disorders in young children, as evidenced by the results obtained. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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Functional constipation in children: What physicians should know

Cited by 20 publications

References 153 publications

The ten “hard” questions in pediatric functional constipation

The ten “hard” questions in pediatric functional constipation

Probiotics for functional constipation in children: an overview of overlapping systematic reviews

Improving an integrated approach to the treatment of functional constipation in children

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