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Childhood constipation

Abdul Waheed, Michael Malone, Samiullah Samiullah
Functional gastrointestinal disorders (FGIDs) are common among children and cause tremendous distress for patients and families. Family physicians should know how to diagnose and manage some of the more common childhood FGIDs. These include infant regurgitation, infant colic, infant dyschezia, cyclic vomiting syndrome, functional nausea and vomiting, functional diarrhea and constipation, abdominal migraine, and nonspecific functional abdominal pain. Diagnosis requires a thorough history and physical examination to rule out red flag signs and symptoms for structural or organic etiologies...
March 2018: FP Essentials
Lily S Cheng, Allan M Goldstein
Constipation is a common childhood problem, but an anatomic or physiologic cause is identified in fewer than 5% of children. By definition, idiopathic constipation is a diagnosis of exclusion. Careful clinical evaluation and thoughtful use of imaging and other testing can help exclude specific causes of constipation and guide therapy. Medical management with laxatives is effective for the majority of constipated children. For those patients unresponsive to medications, however, several surgical options can be employed, including anal procedures, antegrade colonic enemas, colorectal resection, and intestinal diversion...
March 2018: Clinics in Colon and Rectal Surgery
Patricia P Mello, Diego A Eifer, Elza D Mello
OBJECTIVE: To gather current evidence on the use of fiber for constipation treatment in pediatric patients. SOURCE OF DATA: Systematic review with meta-analysis of studies identified through Pubmed, Embase, LILACS and Cochrane databases published up to 2016. INCLUSION CRITERIA: Randomized controlled trials; patients aged between 1 and 18 years and diagnosed with functional constipation receiving or not drug treatment for constipation; articles published in Portuguese, English, Spanish, French, and German in journals accessible to the researchers...
February 20, 2018: Jornal de Pediatria
Michelle Waterham, Jonathan Kaufman, Susan Gibb
BACKGROUND: Constipation is best defined as difficulty passing stools that may be infrequent (≤2 per week), painful and associated with stool retention. Childhood constipation is common, with a prevalence of 3-30% worldwide. Most constipation in children is functional and related to behavioural withholding after an unpleasant stool event. Successful diagnosis and management can occur in primary care, and specialist referral is only needed for refractory cases or concerns regarding organic pathology...
December 2017: Australian Family Physician
Ariani Widodo, Badriul Hegar, Yvan Vandenplas
AIM: To assess the knowledge of general pediatricians througout Indonesia about the diagnosis and treatment of childhood constipation. METHODS: A comprehensive questionnaire was distributed to general pediatricians from several teaching hospitals and government hospitals all over Indonesia. RESULTS: Data were obtained from 100 pediatricians, with a mean of 78.34 ± 18.00 mo clinical practice, from 20 cities throughout Indonesia. Suspicion of constipation in a child over 6 mo of age arises when the child presents with a decreased frequency of bowel movements (according to 87% of participants) with a mean of one bowel movement per 3...
February 8, 2018: World Journal of Clinical Pediatrics
Tracy Liu, Raghu Lingam, Kate Lycett, Fiona K Mensah, Joshua Muller, Harriet Hiscock, Md Hamidul Huque, Melissa Wake
OBJECTIVE: To estimate prevalence and persistence of 19 common paediatric conditions from infancy to 14-15 years. DESIGN: Population-based prospective cohort study. SETTING: Australia. PARTICIPANTS: Parallel cohorts assessed biennially from 2004 to 2014 from ages 0-1 and 4-5 years to 10-11 and 14-15 years, respectively, in the Longitudinal Study of Australian Children. MAIN OUTCOME MEASURES: 19 health conditions: 17 parent-reported, 2 (overweight/obesity, obesity) directly assessed...
February 16, 2018: Archives of Disease in Childhood
Claire Zar-Kessler, Braden Kuo, Jaime Belkind-Gerson
BACKGROUND: Childhood constipation is common. Previously, internal anal sphincterotomy has been used for hypertensive/non-relaxing sphincters; however, recent benefit has been shown with Botulinum Toxin (BT) injections. The aim is to investigate BT, including response duration, symptom association and effectiveness in relation to sphincter dynamics. METHODS: Retrospective study of 164 children receiving sphincter BT for severe constipation unresponsive to medication management...
December 24, 2017: Journal of Pediatric Surgery
I J N Koppen, M Saps, J V Lavigne, S Nurko, J A J M Taminiau, C Di Lorenzo, M A Benninga
BACKGROUND: Evidence for the efficacy of commonly used drugs in the treatment of childhood functional constipation (FC) is scarce, studies are often of low quality and study designs are heterogeneous. Thus, recommendations for the design of clinical trials in childhood FC are needed. PURPOSE: Members of the Rome Foundation and a member of the Pediatric Committee of the European Medicines Agency formed a committee to create recommendations for the design of clinical trials in children with FC...
January 30, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Helena Lindgren, Malin Carvalho Nejstgaard, Martin Salö, Pernilla Stenström
AIM: We evaluated bowel function in healthy children with regard to gender and age. METHODS: The study was carried out in 2016 at a tertiary children's hospital. Healthy children aged 3.5 years to 15 years who were admitted to the hospital, siblings to patients or offspring of staff members were included. Validated self-report questionnaires and internally developed questions regarding obstructive outlet- and gas-related symptoms were used. RESULTS: A total of 310 participants (50% girls) were included, which corresponded to a 94% answer frequency...
January 18, 2018: Acta Paediatrica
Jae Woong Yoon, Du Young Choi, Yeon Kyun Oh, Seung Hyun Lee, Dong Baek Gang, Seung Taek Yu
Mesenteric cysts are rare intra-abdominal lesions occurring during childhood, which were first described in 1507. Cases of mesenteric cysts have been continuously reported, but these cases were very small in number. They are often asymptomatic and incidentally found while patients are undergoing work-up or receiving treatment for other conditions such as appendicitis, small-bowel obstruction, or diverticulitis; however, patients may still have lower abdominal pain and symptoms that are frequently associated with other abdominal conditions...
December 2017: Pediatric Gastroenterology, Hepatology & Nutrition
Robert O Heuckeroth
Hirschsprung disease is defined by the absence of enteric neurons at the end of the bowel. The enteric nervous system (ENS) is the intrinsic nervous system of the bowel and regulates most aspects of bowel function. When the ENS is missing, there are no neurally mediated propulsive motility patterns, and the bowel remains contracted, causing functional obstruction. Symptoms of Hirschsprung disease include constipation, vomiting, abdominal distension and growth failure. Untreated disease usually causes death in childhood because bloodstream bacterial infections occur in the context of bowel inflammation (enterocolitis) or bowel perforation...
January 4, 2018: Nature Reviews. Gastroenterology & Hepatology
J Zhu, M Guo, T Yang, X Lai, Y Y Lei, M L He, J Chen, T Y Li
Objective: To investigate the relationship between gastrointestinal disorders (GID) and core symptoms or behavioral problems among the children with autism spectrum disorder (ASD) . Method: Totally 328 children with ASD and 202 normal controls were enrolled in this cross-sectional study from August 2013 to October 2016. The information about the gastrointestinal disorders, behavioral and emotional problems was collected by using questionnaires. Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC) were used to assess the core symptoms of the children with ASD...
December 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Lisa Philichi
No abstract text is available yet for this article.
January 2018: Journal of Pediatric Health Care
Jean-Pierre Lin
PURPOSE OF REVIEW: In childhood, movement disorders are generated by a very large number of disorders of the nervous system, and the very different developmental ages at which these occur make studies of pharmacotherapy efficacy extremely difficult. In most clinical practices, medication used in management is by trial and error, and limited by lack of efficacy and/or adverse drug reactions leading to drug intolerance. Nevertheless, symptom reduction using polypharmacy must be balanced against any accompanying comorbidities such as poor attention and concentration, constipation, ileus, urinary retention, blurred vision sedation and respiratory depression...
December 2017: Current Opinion in Pediatrics
Tomas Wester, Anna Löf Granström
Hirschsprung disease is a developmental defect of the enteric nervous system characterized by lack of enteric neurons in the distal hindgut. There are numerous reports on short-term outcomes indicating that impaired bowel function is common. Recently, several controlled studies show that bowel function outcomes are affected beyond childhood, in adolescents and adults, compared with healthy control subjects. Constipation and fecal incontinence are common. The impaired bowel function appears to have a negative impact on quality of life, although, a majority of patients have adapted to their symptoms...
October 2017: Seminars in Pediatric Surgery
Rebecca Lauters, Aaron Saguil
No abstract text is available yet for this article.
October 1, 2017: American Family Physician
Sarah B Cairo, Priscilla P L Chiu, Roshni Dasgupta, Karen A Diefenbach, Allan M Goldstein, Nicholas A Hamilton, Andrea Lo, Michael D Rollins, David H Rothstein
BACKGROUND: The provision of timely and comprehensive transition of care from pediatric to adult surgical providers for patients who have undergone childhood operations remains a challenge. Understanding the barriers to transition from a patient and family perspective may improve this process. METHODS: A cross-sectional survey was conducted of patients with a history of anorectal malformation (ARM) or Hirschsprung Disease (HD) and their families. The web-based survey was administered through two support groups dedicated to the needs of individuals born with these congenital abnormalities...
October 7, 2017: Journal of Pediatric Surgery
Xiao-Lan Ying, Zhen-Yan Gao, Jin Yan, Meng Zhang, Ju Wang, Jian Xu, Morri Markowitz, Chong-Huai Yan
OBJECTIVES: This study explored the sources of lead exposure, identified patients' geographic distribution and evaluated the symptoms of children with elevated blood lead levels (BLLs) referred to a pediatric lead specialty clinic in China. MATERIAL AND METHODS: Data were collected from 515 consecutive outpatients attending the Pediatric Lead Poisoning Clinic in Xinhua Hospital, Shanghai, China, between 2011 and 2016, referred for BLLs ≥5 μg/dL. Atomic absorption spectrometry was used to measure venous BLLs...
October 27, 2017: Clinical Toxicology
Ilan J N Koppen, M H Vriesman, M M Tabbers, C Di Lorenzo, M A Benninga
OBJECTIVE: To assess if physicians approach children with functional constipation according to the 2014 ESPGHAN/NASPGHAN guideline. METHODS: We invited pediatricians and pediatric gastroenterologists in the Netherlands and the U.S. to participate in this anonymous survey using a self-developed questionnaire containing 19 multiple-choice questions concerning evaluation and treatment of children with constipation. RESULTS: We included 328 physicians (67% from the U...
October 17, 2017: Journal of Pediatric Gastroenterology and Nutrition
N R Santucci, P E Hyman, A Karpinski, A Rosenberg, D Garguilo, L E Rein, A Amado-Feeley, E Stoops, R E Herdes, M A L van Tilburg
BACKGROUND: Children with functional constipation fear painful bowel movements leading to stool withholding behavior. Self-efficacy is the belief that an individual can accomplish a given goal. If children with constipation avoid defecation because they think that they are unable defecate comfortably, this low self-efficacy may prevent treatment success. The aim of the current study was to develop and validate a constipation specific self-efficacy scale. METHODS: The self-efficacy for functional constipation questionnaire (SEFCQ) was developed by the authors and evaluated by 10 children and seven experts...
October 4, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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