The Paris Consensus on Childhood Constipation Terminology (PACCT) Group

Constipation in Children: Assisting Paediatricians

“…Парижский консенсус по запорам у детей предлага-ет включить в критерии запора 2 или более симптомов на протяжении 8 нед [7]: • дефекация реже 3 раз/нед; • неконтролируемая дефекация чаще 1 раза/нед; • большой объем каловых масс, требующий неоднократ-ного опорожнения смывного бачка; • пальпируемые каловые массы в толстой или прямой кишке; • стремление ребенка к задержке стула; • болезненная дефекация.…”

Çocuklarda fonksiyonel kabızlık tedavisinin yaşam kalitesi üzerine etkisi

“…Çalışmaya dahil edilme şartları çocuğun 2-6 yaş arasında olması, FK tanısı alması, annesi ile birlikte yaşaması, tedavinin anne ile birlikte ve en az 6 hafta boyunca sürdürülmesi, annenin çalışmaya katılmayı ve gerekli ölçekleri doldurmayı kabul etmesi idi. FK tanısı için en az 2 ay boyunca şu 6 belirtiden en az ikisinin karşılanması gerekiyordu: Defekasyon sıklığı <3/ hafta, fekal inkontinans>1/hafta, tuvaleti tıkayabilecek büyüklükte fekal kitle geçişi, fekal kitlenin karın palpasyonunda veya rektal tuşe ile palpe edilebilmesi, kakasını tutma ve ağrılı kaka yapma [22]. Her hastadan detaylı tıbbi öykü alındı.…”

Diagnostic Approach to Constipation in Children

“…Faecal incontinence refers to the passage of stools in an inappropriate place (Benninga et al, 2005). It occurs in 1-3% of children and can affect up to 8% of adults (Catto-Smith, 2005).…”

“…Faecal incontinence: Passage of stools in an inappropriate place  Organic faecal incontinence: faecal incontinence resulting from organic disease  Functional faecal incontinence: nonorganic disease that can be subdivided into: -Constipation-associated faecal incontinence: functional faecal incontinence associated with the presence of constipation -Non-retentive (non-constipation-associated) faecal incontinence: passage of stools in an inappropriate place, occurring in children with a mental age of 4 years and older, with no evidence of constipation based on history and/or examination (Benninga et al, 2005) Rome III criteria Functional constipation: Must include 1 month of at least 2 of the following in infants up to 4 years of age:  Two or fewer defecations per week  At least 1 episode per week of incontinence after the acquisition of toileting skills  History of excessive stool retention  History of painful or hard bowel movements  Presence of a large faecal mass in the rectum  History of large-diameter stools that may obstruct the toilet (Hyman et al, 2006) Functional constipation: Must include 2 or more of the following in a child with a developmental age of at least 4 years with insufficient criteria for diagnosis of irritable bowel syndrome:  Two or fewer defecations in the toilet per week  At least 1 episode of faecal incontinence per week  History of retentive posturing or excessive volitional stool retention  History of painful or hard bowel movements  Presence of a large faecal mass in the rectum  History of large-diameter stools that may obstruct the toilet Criteria must be fulfilled at least once per week for at least 2 months before diagnosis (Rasquin et al, 2006) Non-retentive faecal incontinence: Must include all of the following in a child with a developmental age of at least 4 years:  Defecation into places inappropriate to the social context at least once per month  No evidence of an inflammatory, anatomic, metabolic or neoplastic process that  explains the subject's symptoms No evidence of faecal retention. PACCT also recommended discontinuation of the terms 'encopresis' and 'soiling' and replacement by the term 'faecal incontinence'.…”