The purpose of an article published in Pediatric Health, Medicine and Therapeutics was to update the current knowledge on challenges related to epidemiology, pathophysiology, diagnosis, and management of functional constipation (FC) in children.

Here, the authors reported that there exists a large variation in prevalence of FC. Additionally, the pathophysiology of FC remains obscure and is speculated to be multifactorial. Withholding behavior is likely to be the most important factor among babies and young children. While genetics may also play a role since many patients have a positive family history; mutations in genes associated with FC have not been found.

It was stated that in the recent past, different diagnostic criteria for FC in infants and children have been proposed, including the Rome IV criteria. When compared to Rome III, the Rome IV criteria eliminates two diagnostic parameters in children under the age of 4 who still wear diapers. For the diagnosis of FC, physical examination and taking a thorough medical history have been recommended, whereas other investigations, for instance, abdominal radiography, transabdominal recto-ultrasonography, colonic transit time, are not routinely advised.

Treatment guidelines recommend disimpaction and maintenance therapy with polyethylene glycol (PEG) with or without electrolytes as a first choice. This review found that counseling of parents and children about causes of FC is often neglected. It was stated that behavior therapy added to laxative therapy improves the relief of symptoms of FC in children.