Pediatric Constipation: an Epidemiologic and Physiologic Approach to Guide a Stepwise Approach to its Management
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Pediatric Gastroenterology (S Saeed and K Sandberg, Section Editors)
Pediatric Constipation: an Epidemiologic and Physiologic Approach to Guide a Stepwise Approach to its Management Hayat M. Mousa, MD1,* Jacqueline M. Barsamian, MPH1 Alain J. Benitez, MD2 Jennifer M. Webster, DO2 Kristin N. Fiorino, MD2 Address *,1 Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego, Rady Children’s Hospital, San Diego, 3020 Children’s Way M.C. 5030, San Diego, CA, 92123, USA Email: [email protected] 2 Department of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
* Springer Nature Switzerland AG 2020
This article is part of the Topical Collection on Pediatric Gastroenterology Keywords Pediatrics I Constipation I Fecal incontinence I Defecation disorder I Advanced therapy I Complementary care
Abstract Purpose of review Functional constipation (FC) is a disorder of multifactorial origin that accounts for the vast majority of constipation cases in children and often leads to a significant impact on quality of life. Functional constipation can be challenging to manage due to its mixed etiology. Understanding epidemiologic and physiologic features in the process of defecation is key when choosing an adequate diagnostic and management plan for patients with functional constipation. Recent findings There is a wide range of pharmacologic treatments that can be implemented at initial diagnosis; however, results can significantly vary and sometimes lead to a chronic disease state. At this point, non-pharmacologic or interventional methods can be applied in order to restore a physiologic defecation pattern. This review describes the epidemiology and pathophysiology of FC in addition to current pharmacologic,
Pediatric Gastroenterology (S Saeed and K Sandberg, Section Editors) interventional and complementary treatment options within the pediatric population. Summary FC is a common problem within the pediatric population that must be studied more extensively to better understand its physiology and appropriate treatment. Although many children with FC respond to conventional treatment methods, it is especially important to gain a more thorough understanding of treatment options for children with refractory constipation.
Introduction Constipation which has no identifiable organic causes, also known as functional constipation (FC), is commonly encountered in both children and adults, may arise from a variety of factors, and provides a significant detriment to quality of life (QoL). Although FC is a prevalent condition in the pediatric population, there continues to be a lack of understanding regarding the underlying physiology as well as appropriate treatment choices for this condition. Response to conventional treatment among children with FC is varied, leaving a small subset of children with refractory co
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