• Clinical and Experimental Pediatrics
• /
• v.48 no.4
• /
• pp.355-362
• /
• 2005

Constipation is very common phenomenon during childhood that accounts approximately 3% of general pediatric outpatient visits and up to 25% of visit to the pediatric gastroenterologist. The diagnosis of functional constipation is based on the historical features and absence of physical abnormalities. Most infants and children with chronic constipation require no diagnostic tests. Constipation and subsequent fecal retention behavior often begins soon after experience of painful defecation. The effective management of childhood chronic constipation consist of education, prolonged support by physicians and parents, medications, and long term follow up.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.11 no.sup1
• /
• pp.44-54
• /
• 2008

Chronic functional constipation is a common problem in childhood, with soiling a significant issue. It presents a management problem for pediatrician, and parental concern is high. About 5% of pediatric patients is known to have constipation and/or encopresis which is the second most referred disease in pediatric gastroenterology clinic, accounting for up to 25% of all visits. The etiology of constipation was based on initiation factors including vicious cycle concept, genetic factors, psychological factors, dietary influences and histologic abnormalities of colon. Emphasis is placed on the evaluation and management options that are available to the treating pediatrician. Careful history taking is most important to diagnose functional constipation. In addition, diagnostic tests such as plain abdominal radiograph, colonic transit study, anorectal manometry, barium enema were helpful to diagnose the constipation. Childhood constipation can be very delicate to treat. It often requires prolonged supports by physicians and parents, demystification, medical treatment and especially with the child and parent's cooperation.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.17 no.3
• /
• pp.155-161
• /
• 2014

Purpose: Constipation is a common pediatric problem worldwide. This study aims to describe the clinical characteristics of pediatric constipation in south Jordan according to gender and age group. Methods: All patients with constipation managed at our pediatric gastroenterology service between September 2009 and December 2012 were included. Hospital charts were reviewed. Demographic data, clinical characteristics, and final diagnosis were recorded. Data were analyzed according to gender and the following age groups: infants, pre-school, school age, and adolescents. Results: During the study period, 126 patients were enrolled. The number (percentage) of patients according to age were the following infants: 43 (34.1%), pre-school: 55 (43.7%), school age: 25 (19.8%), and adolescents: 3 (2.4%). Males made up 54.8% of the study population. There were no statistical gender differences in any age group. The most common symptom in all age groups was dry, hard stool. Infrequent defecation was found in almost one-half of the patients. Fecal incontinence was more common in school-aged children compared to pre-school-aged children and adolescents. Abdominal pain was seen in almost 40% of the constipated children. Abdominal pain was more prevalent in girls and older children. Fecal mass in the rectum was the most common physical finding, with constipated boys exhibiting higher rates. Functional constipation was the most common etiology. Conclusion: Clinical characteristics of constipation in children vary according to age group and gender. Older children had less frequent bowel motions, a longer duration of symptoms, and a higher prevalence of long-standing constipation compilations (fecal incontinence and abdominal pain).

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.13 no.2
• /
• pp.23-34
• /
• 2018

Objectives : This review aims to evaluate the effects and the safety of Chuna manual therapy(CMT) for pediatric functional constipation. Methods : We searched 10 electronic databases(Pubmed, EMBASE, Cochrane Library, CAJ, Oasis, RISS, KISS, NDSL, KMBASE, KISTI) and related 2 journals until October 2018. We included randomized controlled trials(RCTs) of testing CMT for pediatric functional constipation. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool. Results : 16 RCTs were eligible in our inclusion criteria. The meta-analysis of 11 studies showed positive for use CMT for pediatric functional constipation. CMT significantly improved total efficancy rate compared with medications (P < 0.00001). Conclusions : There is evidence of CMT for pediatric functional constipation with meta-analysis. However, our systematic review has limited evidence to support CMT for pediatric functional constipation. because the quality of relevant trials is relatively poor. Further well-designed RCTs should be encouraged. the quality of relevant trials is relatively poor.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.17 no.4
• /
• pp.203-208
• /
• 2014

Chronic constipation is a very common disease in children. Successful treatment of constipation can be achieved not only with medication but also with lifestyle changes, including a proper diet. Diets including fruits, fluids, and probiotics are good for constipation. Some dietary components are helpful for constipation, and some are harmful. In this study, we present diets related to constipation from the literature, and propose some perspectives regarding diets related to constipation.

• The Journal of Pediatrics of Korean Medicine
• /
• v.34 no.4
• /
• pp.59-76
• /
• 2020

Objectives The purpose of this study is to analyze the trends of recent clinical studies on the effect of herbal medicine for pediatric constipation in China, and to evaluate the efficacy and safety of herbal medication treatment for pediatric constipation. Methods The authors searched the clinical studies using China National Knowledge Infrastructure (CNKI) published from January 2016 to June 2020. We analyzed the literature in regards to focusing on the treatment methods and results. Results A total of 29 randomized controlled trials were selected and analyzed. In all the those studies, the total effective rate of herbal medicine treatment group in pediatric constipation was significantly higher than those of the control group. The most commonly used herbs for pediatric constipation were Atractylodis Rhizoma Alba (白朮) followed by Aurantii Immaturus Fructus (枳實), Glycyrrhizae Radix (甘草), Semen Cannabis (火麻仁), Raphani Semen (萊菔子). The recurrence rate of the herbal medicine treatment group was significantly lower than those of control group. In most studies, the adverse events from the herbal medicine treatment group were significantly less than those of the control group. Conclusions Based on the results of the analyzed clinical studies, herbal medicine treatment has been shown to be safe and effective in the treatment of pediatric constipation. Additional clinical studies are needed to solidify these findings.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.24 no.1
• /
• pp.45-53
• /
• 2021

Purpose: We aimed to compare the prevalence rates and associated symptoms of constipation and fecal incontinence in children and young adults and evaluate how these patient groups cope with these disorders. Methods: A cross-sectional study was performed in which 212 children (8-17 years) and 149 young adults (18-29 years) from the general Dutch population completed a questionnaire about defecation disorders. Results: Constipation occurred in 15.6% of children and 22.8% of young adults (p=0.55), while the prevalence of fecal incontinence was comparable between groups (7%, p=0.91). The symptoms associated with constipation occurred as often in children as in young adults, while most fecal incontinence symptoms occurred more often in young adults. Approximately 43% of children had constipation for more than 5 years, while 26% of young adults experienced constipation since childhood. Only 27% of constipated children and 21% of constipated young adults received treatment (mostly laxatives). For fecal incontinence, 13% of children and 36% of young adults received treatment (mostly antidiarrheal medications or incontinence pads). Conclusion: In contrast to the general belief, the prevalence of defecation disorders and associated symptoms seem to be comparable in children and young adults. Only a few people with defecation disorders receive adequate treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.21 no.1
• /
• pp.28-33
• /
• 2018

Purpose: To evaluate the efficacy of synbiotic formula with partial whey hydrolysate and high magnesium content in infants presenting with functional constipation. Methods: Sixty-five infants with functional constipation were included. Forty infants were treated during one month with parental reassurance and the intervention formula and were compared to a control group of 25 infants treated with parental reassurance only. Parents completed a quality of life (QoL) questionnaire at baseline and during the last week of the study. Results: At inclusion, stool characteristics and QoL were similar in both groups. The control group was slightly older than the intervention group ($7.5{\pm}3.9$ vs. $6.2{\pm}3.6$ weeks). At onset, stool composition was "hard and tight" (Bristol stool scale 1 and 2) in all infants. After one month, stool composition remained unchanged in the control group except in two infants that developed "creamy" stools (Bristol stool scale type 3 and 4). In the intervention group, stools remained "hard and tight" in 27.5%, and became "creamy" in 47.5%, "loose" (Bristol stool scale type 5) in 22.5% and "watery" (Bristol stool type 6 and 7) in 2.5%. The benefit of the intervention formula was estimated to be "very important" in 70%. The median scores for QoL improved significantly in the intervention group for all parameters and for one in the control group. Conclusion: The intervention formula significantly improved functional constipation resulting in a better QoL of the parents and infants.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.25 no.3
• /
• pp.163-179
• /
• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.12 no.sup1
• /
• pp.111-117
• /
• 2009

Constipation is one of the most common symptoms that a child visits pediatrician. The general approach to the child with functional constipation includes the following steps; disimpaction, maintenance and withdrawal of medication. There are many drugs which can be applied to children; osmotic agents (lactulose, sorbitol, magnesium hydroxide/citrate, polyethylene glycol with/without electrolytes, sodium phosphate, glycerin), stimulants (senna, bisacodyl, caster oil), lubricant (mineral oil), bulking agent (psyllium, cellulose, glucomannan). At each stage of treatment, one or some of these drug can be applied to the purpose. The author tries to summarize recent studies on drugs for constipation in child, and finally introduces new dugs for constipation which is under investigation.