Nutrition Publication

Constipation

Editor(s): International Committee of Paediatricians. 65 / 2

Editorial The Pathophysiology of Constipation Diagnosis of Constipation in Children Current Treatment of Childhood Constipation Functional Fecal Incontinence in Children This publication is not available online yet. You can buy it on the Karger website

Related Articles

Editorial

Author(s): The Editorial Committee

Editorial The Pathophysiology of Constipation Diagnosis of Constipation in Children Current Treatment of Childhood Constipation Functional Fecal Incontinence in Children This publication is not available online yet. You can buy it on the Karger website

The Pathophysiology of Constipation

Author(s): P.J. Milla

Constipation is an extremely common disorder in childhood and is responsible for up to 25%of  all  pediatric  gastroenterological consultations and 3% of all pediatric outpatient visits. In 90% of the cases the disorder is functional in origin and in only 10% is there an underlying organic disorder.Common organic causes of childhood constipation include:congenital defects of the gut; neurologic disease especiallycerebral palsy, spinal cord disorders and hypotonia; endocrine and metabolic disorders (hypothyroidism, cystic fibrosis, hypercalcemia, diabetes mellitus, renal acidosis), and the use of constipating drugs such as some antacids, sucralfate, iron, codeine-containing medications, imipramine, phenytoin, etc. The commonest of the congenital defects isHirschsprung’s disease, which has an incidence of 1 in 4,500live births compared to 1 in 7,000 live births with anorectalmalformations, and 1 in 40,000 with other enteric neuromuscular disorders. Fewer than 5% of children presenting for the first time with constipation have demonstrable organic disease...

Diagnosis of Constipation in Children

Author(s): F. Sauvat

Constipation is a frequent reason for consulting a pediatrician.As a symptom, constipation can be due to various etiologiesin terms of frequency, nature and seriousness. Constipationmay be of medical or surgical origin or idiopathic.Surgical etiologies are mainly represented by Hirschsprung’sdisease. It is the main differential diagnosis even if it is 50times less frequent than idiopathic or functional constipation.A thorough history and physical examination, includinganal examination, are the best way to reach a diagnosis.No other examination is required in most of the cases and allinvestigations have to be managed according to clinical considerations...

Functional Fecal Incontinence in Children

Author(s): M.E.J. Bongers, M.A. Benninga

Fecal incontinence is defined as the passage of stools in an inappropriate place. This frustrating symptom is a source ofconsiderable distress and embarrassment for the child andhis/her family. Pediatric fecal incontinence can be dividedinto 2 main categories: organic fecal incontinence, e.g.,resulting from anorectal malformations or neurogenic abnormalities,and functional fecal incontinence. This review will only address functional fecal incontinence in children, and the definition, epidemiology, pathophysiology and recent updates on the clinical and diagnostic aspects of functional fecal incontinence will be discussed.

Current Treatment of Childhood

Author(s): O. Liem, C. Di Lorenzo, J.A.J.M. Taminiau, H.M. Mousa, M.A. Benninga

Childhood constipation is a worldwide problem. It is one ofthe more common complaints presented to both generalpediatricians and pediatric gastroenterologists. Treatmentfor chronic constipation is challenging and often requireslong-term follow-up and medication use. Despite its highprevalence, few randomized trials have been performed toinvestigate the efficacy of different interventions used totreat this condition. In this review we will discuss currenttreatment options for childhood constipation and addresssome of the most frequently asked questions and misconceptions among parents and physicians.