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Childhood constipation: Current status, challenges, and future perspectives

Constipation in children is a major health issue around the world, with a global prevalence of 9.5%. They present to clinicians with a myriad of clinical signs. The Rome IV symptom-based criteria are used to diagnose functional constipation. Functional constipation is also a huge financial burden fo...

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Autores principales: Rajindrajith, Shaman, Devanarayana, Niranga Manjuri, Benninga, Marc A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9516492/
https://www.ncbi.nlm.nih.gov/pubmed/36185096
http://dx.doi.org/10.5409/wjcp.v11.i5.385
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author Rajindrajith, Shaman
Devanarayana, Niranga Manjuri
Benninga, Marc A
author_facet Rajindrajith, Shaman
Devanarayana, Niranga Manjuri
Benninga, Marc A
author_sort Rajindrajith, Shaman
collection PubMed
description Constipation in children is a major health issue around the world, with a global prevalence of 9.5%. They present to clinicians with a myriad of clinical signs. The Rome IV symptom-based criteria are used to diagnose functional constipation. Functional constipation is also a huge financial burden for healthcare system and has a detrimental impact on health-related quality of life of children. There are various risk factors identified globally, including centrally connected factors such as child abuse, emotional and behavioral issues, and psychological stress. Constipation is also precipitated by a low-fiber diet, physical inactivity, and an altered intestinal microbiome. The main pathophysiological mechanism is stool withholding, while altered rectal function, anal sphincter, pelvic floor, and colonic dysfunction also play important roles. Clinical evaluation is critical in making a diagnosis, and most investigations are only required in refractory patients. In the treatment of childhood constipation, both nonpharmacological (education and de-mystification, dietary changes, toilet training, behavioral interventions, biofeedback, and pelvic floor physiotherapy), and pharmacological (osmotic and stimulant laxatives and novel drugs like prucalopride and lubiprostone) interventions are used. For children with refractory constipation, transanal irrigation, botulinum toxin, neuromodulation, and surgical treatments are reserved. While frequent use of probiotics is still in the experimental stage, healthy dietary habits, living a healthy lifestyle and limiting exposure to stressful events, are all beneficial preventive measures.
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spelling pubmed-95164922022-09-29 Childhood constipation: Current status, challenges, and future perspectives Rajindrajith, Shaman Devanarayana, Niranga Manjuri Benninga, Marc A World J Clin Pediatr Frontier Constipation in children is a major health issue around the world, with a global prevalence of 9.5%. They present to clinicians with a myriad of clinical signs. The Rome IV symptom-based criteria are used to diagnose functional constipation. Functional constipation is also a huge financial burden for healthcare system and has a detrimental impact on health-related quality of life of children. There are various risk factors identified globally, including centrally connected factors such as child abuse, emotional and behavioral issues, and psychological stress. Constipation is also precipitated by a low-fiber diet, physical inactivity, and an altered intestinal microbiome. The main pathophysiological mechanism is stool withholding, while altered rectal function, anal sphincter, pelvic floor, and colonic dysfunction also play important roles. Clinical evaluation is critical in making a diagnosis, and most investigations are only required in refractory patients. In the treatment of childhood constipation, both nonpharmacological (education and de-mystification, dietary changes, toilet training, behavioral interventions, biofeedback, and pelvic floor physiotherapy), and pharmacological (osmotic and stimulant laxatives and novel drugs like prucalopride and lubiprostone) interventions are used. For children with refractory constipation, transanal irrigation, botulinum toxin, neuromodulation, and surgical treatments are reserved. While frequent use of probiotics is still in the experimental stage, healthy dietary habits, living a healthy lifestyle and limiting exposure to stressful events, are all beneficial preventive measures. Baishideng Publishing Group Inc 2022-09-09 /pmc/articles/PMC9516492/ /pubmed/36185096 http://dx.doi.org/10.5409/wjcp.v11.i5.385 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Frontier
Rajindrajith, Shaman
Devanarayana, Niranga Manjuri
Benninga, Marc A
Childhood constipation: Current status, challenges, and future perspectives
title Childhood constipation: Current status, challenges, and future perspectives
title_full Childhood constipation: Current status, challenges, and future perspectives
title_fullStr Childhood constipation: Current status, challenges, and future perspectives
title_full_unstemmed Childhood constipation: Current status, challenges, and future perspectives
title_short Childhood constipation: Current status, challenges, and future perspectives
title_sort childhood constipation: current status, challenges, and future perspectives
topic Frontier
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9516492/
https://www.ncbi.nlm.nih.gov/pubmed/36185096
http://dx.doi.org/10.5409/wjcp.v11.i5.385
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