Proposals to Approximate the Pediatric Rome Constipation Criteria to Everyday Practice

Maffei, Helga Verena L.; Morais, Mauro Batista de

doi:10.1590/s0004-2803.201800000-44

Cited by 5 publications

(7 citation statements)

References 56 publications

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“…Low colonic pH may have contributed to in vivo non-H, production in some children, secondary to diet, acute diarrhea, or chronic carbohydrate malabsorption. Reduced breath Hz responses have been reported in children with acute gastroenteritis and clinical monosaccharide intolerance (22,23), and we have recently identified a high prevalence of rice carbohydrate malabsorption in Burmese village children (7,8), conditions which generally produce acidic fecal contents (15,24). Our findings suggest that some enteric bacteria associated with small bowel overgrowth may not be capable of producing Hz (at least in the in vitro system used).…”

Section: Discussionmentioning

confidence: 58%

In Vitro Hydrogen Production by Enteric Bacteria Cultured from Children with Small Bowel Bacterial Overgrowth

Khin‐Maung‐U,

Tin‐Aye,

Ku‐Tin‐Myint

et al. 1992

J. pediatr. gastroenterol. nutr.

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SummaryLactulose breath hydrogen test and Enterotest string test were carried out simultaneously on 19 children 3–5 years old. Bacteria isolated from the jejunal fluid in upper small intestines of these children were incubated with lactulose at neutral pH. Anaerobes were present in all but one child, and in 15 children they were present in numbers greater than 5 log10 organisms per ml. Most of these bacteria did not produce hydrogen in vitro. Hydrogen production (>100 ppm) was observed with the following bacteria: Bacteroides (5%), Clostridia (8%), anaerobic corynebacteria (5%), Escherichia coli (67%), Lactobacillus (8%), Staphylococcus (8%), and Streptococcus (9%). The following bacteria did not produce hydrogen in vitro: Actinobacter, Actinomyces, anaerobic cocci, Bifidobacterium, Fusobacterium, micrococci, Neisseria, Sarcina, and Veillonella. This study suggests that in the diagnosis of small bowel bacterial overgrowth using lactulose breath hydrogen test, it is important to consider that patients with a flat breath hydrogen response to a carbohydrate challenge during the first 60 min may be infected with enteric bacteria which are not capable of producing H2.

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Section: Discussionmentioning

confidence: 58%

In Vitro Hydrogen Production by Enteric Bacteria Cultured from Children with Small Bowel Bacterial Overgrowth

Khin‐Maung‐U,

Tin‐Aye,

Ku‐Tin‐Myint

et al. 1992

J. pediatr. gastroenterol. nutr.

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“… 22 Constipation, as a nosological entity, is defined by the presence of clinical manifestations. 23 However, among the proposed definition of symptoms required to diagnose constipation, no definition or proposed set of criteria is comprehensive enough to identify all patients suffering from this condition in clinical practice. The lack of a comprehensive consensus definition impairs not only clinical practice, but also epidemiological conclusions or comparisons and, particularly, the inclusion of subjects into clinical studies.…”

Section: Discussionmentioning

confidence: 99%

“…According to Littlewood, 23 in addition to history and physical exam, abdominal radiography would be useful not only for diagnosis, but also for evaluation of the therapeutic result. The ESPGHAN 12 and CFF 25 definitions agree with the presence of excessive fecal retention in the large intestine, but performing a simple abdominal radiography to diagnose and manage constipation and fecal retention is not a consensus recommendation among the authors.…”

Section: Discussionmentioning

confidence: 99%

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

Stefano

Poderoso

Mainz³

et al. 2020

Jornal de Pediatria

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“…We term this semi-occult constipation (SOC), since -like OC-this previously unrecognized constipation is recognizable when properly approached (2,14,24) . Thus, we aimed to quantify the frequency of OC and of SOC in children with MNE or NMNE refractory to behavioral therapy and who initially deny constipation, using the Boston diagnostic criteria (19) (which allow diagnosis at initial stages (25) ) and the Barr score (22) , considering that many, mainly those with NMNE, can potentially benefit from treatment of a detected constipation (2)(3)(4)14,15,17) .…”

Section: Introductionmentioning

confidence: 99%

Occult and Semi-Occult Constipation in Children With Monosymptomatic or Non Monosymptomatic Enuresis

MAFFEI,

VIDOLIN,

REIS

et al. 2023

Arq. Gastroenterol.

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Background: Functional constipation and enuresis frequently coexist. Constipation treatment often results in resolution or improvement of the enuresis. However, besides the classical presentation, patients can present with occult constipation (OC) diagnosed in complementary evaluation; in addition, semi-occult constipation (SOC) can be detected by means of a detailed questionnaire. Objective: To quantify OC and SOC frequency in children with monosymptomatic or non monosymptomatic enuresis (MNE or NMNE). Methods: Otherwise healthy children/adolescents, with enuresis refractory to behavioral therapy and denying constipation after simple questions, answered a structured bowel habit questionnaire and were submitted to a plain abdominal radiological exam. Constipation was classified considering the Boston diagnostic criteria (to allow diagnosis at initial stages), and fecal loading in the X-ray quantified ≥10 by the Barr score. Children with constipation received a standardized treatment (except 26 “pilot” children). Results: Out of 81 children, 80 aged 9.34±2.07 years, 52.5% male, were diagnosed with constipation: 30 OC, 50 SOC; 63.75% had MNE, 36.25% NMNE (six NMNE without behavioral therapy). Demographic data and the Barr score were similar for OC and SOC, but SOC children experienced significantly more constipation complications (retentive fecal incontinence and/or recurrent abdominal pain). Not showing the Bristol Stool Scale (BSS) to 24 “pilot” children, or absence of constipation symptoms accompanying BSS predominantly type 3, in 13 children, did not significantly impact the detection of constipation by the Barr score. Children identifying BSS 3 or ≤2 had similar results. Twenty-eight children, with adequate follow-up after treatment, improved or recovered from constipation at 44 of their 52 follow-up visits. Conclusion: In patients with MNE or NMNE refractory to behavioral therapy, and who initially denied constipation after simple questions, a detailed questionnaire based on the Boston diagnostic criteria detected SOC in 61.7%, and the radiological Barr score revealed fecal loading (OC) in 37.0% of them.

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Proposals to Approximate the Pediatric Rome Constipation Criteria to Everyday Practice

Abstract: For diagnosis and treatment of pediatric constipation in primary care, one constipation sign/symptom should suffice. The recommended daily dietary fiber intake, according to the American Health Foundation, should be detailed as a treatment measure, and also for prevention, from weaning on.

Cited by 5 publications

References 56 publications

In Vitro Hydrogen Production by Enteric Bacteria Cultured from Children with Small Bowel Bacterial Overgrowth

In Vitro Hydrogen Production by Enteric Bacteria Cultured from Children with Small Bowel Bacterial Overgrowth

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

Occult and Semi-Occult Constipation in Children With Monosymptomatic or Non Monosymptomatic Enuresis

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