Prevalence of constipation in cystic fibrosis patients: a systematic review of observational studies

Stefano, Marina Abib; Poderoso, Rosana Evangelista; Mainz, Jochen G.; Ribeiro, José Dirceu; Ribeiro, Antonio Fernando; Lomazi, Elizete Aparecida

doi:10.1016/j.jped.2020.03.004

Cited by 9 publications

(7 citation statements)

References 26 publications

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“…As per the literature, the prevalence of constipation in children and adolescents with CF ranges from 32% to 57% (1)(2)(3)(4)(5)(6)(7). This considerable variability, at least in part, is because studies have used different diagnostic criteria.…”

Section: Discussionmentioning

confidence: 99%

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Colonic Transit Time and Fecal Impaction in Children and Adolescents With Cystic Fibrosis-associated Constipation

Sillos¹,

Chiba

Soares³

et al. 2021

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Background: Constipation is prevalent in pediatric cystic fibrosis (CF) patients and colonic motility has not been studied in this population. In this study, we aimed to evaluate the total and segmental colonic transit time in children and adolescents with CF based on the presence of constipation and radiological fecal impaction. Methods: In this case series, all patients aged 3 to 20 years of a CF reference center were invited to participate. CF-associated constipation was diagnosed based on the European Society for Paediatric Gastroenterology Hepatology and Nutrition criteria. Total and segmental colonic transit time was determined using radiopaque markers. Fecal impaction on plain abdominal radiography was assessed based on the Barr score. Results: Of the 43 eligible patients, 34 (79%) agreed to participate. Constipation was found in 44.1% of children and adolescents, predominantly in girls. The total colonic transit time (medians of 42 and 24 hours, respectively, P ¼ 0.028) and the segmental right colon transit time (medians of 8 and 2 hours, respectively, P ¼ 0.012) were significantly longer in CF-associated constipation group than in the group of patients without constipation. The frequency of radiological fecal impaction was similar in patients with (50.0%) and without (64.2%) CF-associated constipation (P ¼ 0.70). There was no relationship between radiological fecal impaction and the total and segmental colonic transit time. Conclusions: Children and adolescents with CF-associated constipation had a longer total and segmental right colon transit time. Colonic transit time was similar in patients with and without radiological fecal impaction.

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Section: Discussionmentioning

confidence: 99%

“…Constipation is a common gastrointestinal manifestation in cystic fibrosis (CF) (1–7). It often manifests only through abdominal pain and distension, with no change in bowel movement frequency, which may hinder diagnosis (8).…”

mentioning

confidence: 99%

Colonic Transit Time and Fecal Impaction in Children and Adolescents With Cystic Fibrosis-associated Constipation

Sillos¹,

Chiba

Soares³

et al. 2021

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…Cystic fibrosis also needs to be excluded in a newborn with delayed passage of meconium. As a matter of fact, the prevalence of constipation in cystic fibrosis patients is quite high, ranging widely from 10 to 57% [ 56 ].…”

Section: What Is the Differential Diagnosis?mentioning

confidence: 99%

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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“…Refractory constipation is a frequent but still insufficiently assessed complaint of cystic fibrosis patients. 22 …”

Section: Etiology Of Chronic Refractory Constipationmentioning

confidence: 99%

“…Refractory constipation is a frequent but still insufficiently assessed complaint of cystic fibrosis patients. 22 Colon and anorectal malformations occur in approximately 1 out of every 5000 births and are slightly more common in males. 23 Anorectal malformation is a common cause of constipation in neonates and infants.…”

Section: Etiology Of Chronic Refractory Constipationmentioning

confidence: 99%

Chronic Refractory Constipation in Children: Think Beyond Stools

Hasosah

2021

Global Pediatric Health

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Chronic refractory constipation (CRC) is defined as children who are unable to pass stools in spite of being on maximum laxative therapy and require daily rectal stimulation in the form of enemas or suppositories to pass stools for >3 months. Children are often referred for treatment of refractory constipation that may result from uncontrolled underlying disease or ineffective treatment. Constipated children can be managed by a variety of medical therapeutic options that yield satisfying results in most cases. However, a subset of constipated children fails to benefit from conventional treatments. On treatment failure or on suspicion of organic disease the patient should be referred for further evaluation. Treatment options for treatment-resistant patients are presented. Pharmalogical and non-pharmalogical treatment modalities are reviewed and an algorithm for refractory constipation in children are presented.

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Prevalence of constipation in cystic fibrosis patients: a systematic review of observational studies

Cited by 9 publications

References 26 publications

Colonic Transit Time and Fecal Impaction in Children and Adolescents With Cystic Fibrosis-associated Constipation

Colonic Transit Time and Fecal Impaction in Children and Adolescents With Cystic Fibrosis-associated Constipation

The ten “hard” questions in pediatric functional constipation

Chronic Refractory Constipation in Children: Think Beyond Stools

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