Functional constipation in children: challenges and solutions.


eMediNexus    28 February 2018

An article published in Pediatric Health, Medicine and Therapeutics was based on a review of the available knowledge on functional constipation (FC) in children regarding epidemiology, pathophysiology, diagnosis, and management. The article reported that the global burden and pathophysiology of FC remains obscure. It was speculated that the pathophysiology of FC is multifactorial, and that withholding behavior is probably the most important causative factor in toddlers and young children. In addition, genetics may also play a part since many patients have positive family history; however, mutations in genes associated with FC have not been found. It was stated that when compared to the Rome III diagnostic criteria, the recently released Rome IV diagnostic criteria for FC eliminates two criteria in children under the age of 4, who still wear diapers. The article discussed that in these patients physical examination and a thorough medical history are recommended, but other investigations such as abdominal radiography, transabdominal recto-ultrasonography, colonic transit time, rectal biopsies, and colon manometry are not routinely recommended. Moreover, counseling of parents and children about causes of FC is often neglected. But, recent studies suggest that behavior therapy compliments conventional therapy in improving and relieving symptoms.

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