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Childhood constipation

Manisha Balwani, Preeti Singh, Anju Seth, Ekta Malik Debnath, Hetanshi Naik, Dana Doheny, Brenden Chen, Makiko Yasuda, Robert J Desnick
Acute Intermittent Porphyria (AIP), an autosomal dominant inborn error of heme metabolism, typically presents in adulthood, most often in women in the reproductive age group. There are limited reports on the clinical presentation in children, and in contrast to the adults, most of the reported pediatric cases are male. While acute abdominal pain is the most common presenting symptom in children, seizures are commonly seen and may precede the diagnosis of AIP. As an example, we report a 9year old developmentally normal pre-pubertal boy who presented with acute abdominal pain, vomiting and constipation followed by hyponatremia, seizures, weakness and neuropathy...
October 15, 2016: Molecular Genetics and Metabolism
Ruey Terng Ng, Way Seah Lee, Hak Lee Ang, Kai Ming Teo, Yee Ian Yik, Nai Ming Lai
BACKGROUND: Childhood constipation is a common problem with substantial health, economic and emotional burdens. Existing therapeutic options, mainly pharmacological, are not consistently effective, and some are associated with adverse effects after prolonged use. Transcutaneous electrical stimulation (TES), a non-pharmacological approach, is postulated to facilitate bowel movement by modulating the nerves of the large bowel via the application of electrical current transmitted through the abdominal wall...
October 12, 2016: Cochrane Database of Systematic Reviews
Reiko Hatori, Takeshi Tomomasa, Takashi Ishige, Maiko Tatsuki, Hirokazu Arakawa
BACKGROUND: To assess the usefulness of rectal diameter measurement via ultrasonography as a diagnostic tool for fecal retention in children. METHODS: One hundred children (median age: 5.0 years), consisting of 80 with functional constipation and 20 without constipation, participated in the study. All patients underwent physical examination that included digital rectal examination. Forty-five children underwent ultrasonography in three differential planes: transection above the symphysis, under the ischial spine, and at the bladder neck...
October 5, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Marieke L van Engelenburg-van Lonkhuyzen, Esther M J Bols, Marc A Benninga, Wim A Verwijs, Rob A de Bie
BACKGROUND & AIMS: Functional constipation (FC) is a common childhood problem often related to pelvic floor muscle dysfunction. We compared the effectiveness of pelvic physiotherapy (PPT) vs standard medical care (SMC) in children with FC. METHODS: We performed a multicenter randomized controlled trial of 53 children (5-16 years old) with FC according to the Rome III criteria, at hospitals in The Netherlands from December 2009 to May 2014. Group allocation was concealed using a central computer system...
September 17, 2016: Gastroenterology
Pedro Luiz Toledo de Arruda Lourenção, Simone Antunes Terra, Erika Veruska Paiva Ortolan, Maria Aparecida Marchesan Rodrigues
Intestinal neuronal dysplasia type B (IND-B) is a controversial entity among the gastrointestinal neuromuscular disorders. It may occur alone or associated with other neuropathies, such as Hirschsprung's disease (HD). Chronic constipation is the most common clinical manifestation of patients. IND-B primarily affects young children and mimics HD, but has its own histopathologic features characterized mainly by hyperplasia of the submucosal nerve plexus. Thus, IND-B should be included in the differential diagnoses of organic causes of constipation...
August 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
Shaman Rajindrajith, Niranga Manjuri Devanarayana, Bonaventure Jayasiri Crispus Perera, Marc Alexander Benninga
Functional constipation (FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a high prevalence (0.7%-29%) worldwide, both in developed and developing countries. Biopsychosocial risk factors such as psychological stress, poor dietary habits, obesity and child maltreatment are commonly identified predisposing factors for FC...
August 14, 2016: World Journal of Gastroenterology: WJG
Morris Gordon, John K MacDonald, Claire E Parker, Anthony K Akobeng, Adrian G Thomas
BACKGROUND: Constipation within childhood is an extremely common problem. Despite the widespread use of osmotic and stimulant laxatives by health professionals to manage constipation in children, there has been a long standing paucity of high quality evidence to support this practice. OBJECTIVES: We set out to evaluate the efficacy and safety of osmotic and stimulant laxatives used to treat functional childhood constipation. SEARCH METHODS: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Cochrane IBD Group Specialized Trials Register from inception to 10 March 2016...
2016: Cochrane Database of Systematic Reviews
Subhashis Mitra, Sanghamitra Mukherjee, Hema Chakraborty
Ganglioneuromatous proliferation in the gastrointestinal tract is a rare occurrence and is usually associated with specific syndrome complexes such as multiple endocrine neoplasia Type 2B or von Recklinghausen's disease. We report here a case of diffuse intestinal ganglioneuromatosis, presenting as intestinal obstruction and chronic constipation in an 11-year-old boy. Sporadic cases of intestinal ganglioneuromatosis in the absence of any systemic manifestations are a very rare cause of enteric motility disorders in childhood, and we discuss the pathological and clinical significance of this finding...
July 2016: Indian Journal of Pathology & Microbiology
Mario C Vieira, Isadora Carolina Krueger Negrelle, Karla Ulaf Webber, Marjorie Gosdal, Sabine Krüger Truppel, Solena Ziemer Kusma
OBJECTIVE: To evaluate the pediatrician's knowledge regarding the diagnostic and therapeutic approach of childhood functional constipation. METHODS: A descriptive cross-sectional study was performed with the application of a self-administered questionnaire concerning a hypothetical clinical case of childhood functional constipation with fecal incontinence to physicians (n=297) randomly interviewed at the 36th Brazilian Congress of Pediatrics in 2013. RESULTS: The majority of the participants were females, the mean age was 44...
June 17, 2016: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
Silvia Salvatore, Salvatore Barberi, Osvaldo Borrelli, Annamaria Castellazzi, Dora Di Mauro, Giuseppe Di Mauro, Mattia Doria, Ruggiero Francavilla, Massimo Landi, Alberto Martelli, Vito Leonardo Miniello, Giovanni Simeone, Elvira Verduci, Carmen Verga, Maria Assunta Zanetti, Annamaria Staiano
BACKGROUND: Functional gastrointestinal disorders (FGIDs) are chronic or recurrent gastrointestinal symptoms without structural or biochemical abnormalities. FGIDs are multifactorial conditions with different pathophysiologic mechanisms including altered motility, visceral hyperalgesia, brain-gut disturbance, genetic, environmental and psychological factors. Although in most cases gastrointestinal symptoms are transient and with spontaneous resolution in infancy multiple dietary changes and pharmacological therapy are often started despite a lack of evidence-based data...
2016: Italian Journal of Pediatrics
Shaman Rajindrajith, Niranga Manjuri Devanarayana, Marc Alexander Benninga
OBJECTIVE: The aim of this study is to compare functional constipation (FC) and constipation predominant irritable bowel syndrome (IBS-C) in adolescents. METHOD: A school based survey was conducted involving adolescents aged 13-18 years. A set of validated questionnaires including Rome III questionnaire for functional gastrointestinal disorders in children/adolescents, somatization inventory, quality of life inventory, and childhood traumatic events inventory were used for data collection...
July 11, 2016: Journal of Pediatric Gastroenterology and Nutrition
Denys Gibbons, Michael Camilleri, Alfred D Nelson, Deborah Eckert
BACKGROUND: Gastrointestinal symptoms are frequent in multiple endocrine neoplasia (MEN) 2B and may be related to megacolon. OBJECTIVE: The objective of this article is to review the clinical features of patients with MEN 2B, particularly megacolon. METHODS: We used natural language processing of electronic medical records of Mayo Clinic patients over 20 years: Eight patients with definite MEN 2B were identified; of these, four had megacolon...
June 2016: United European Gastroenterology Journal
Ruggiero Francavilla, Fernanda Cristofori, Flavia Indrio
PURPOSE OF REVIEW: To report the indications and/or recommendations by Societies and Institutions for the use of probiotics and prebiotics in functional intestinal disorders in childhood. RECENT FINDINGS: A position by Societies and Institutions is available only for infant colic, irritable bowel syndrome and constipation. Supplementation with the probiotic L reuteri DSM 17938 in breastfed term infants with colic appears to be effective in reducing crying, while still debated is its role in the prevention of colic...
July 2016: Journal of Pediatric Gastroenterology and Nutrition
Ruey Terng Ng, Way Seah Lee, Hak Lee Ang, Kai Ming Teo, Yee Ian Yik, Nai Ming Lai
BACKGROUND: Childhood constipation is a common problem with substantial health, economic and emotional burdens. Existing therapeutic options, mainly pharmacological, are not consistently effective, and some are associated with adverse effects after prolonged use. Transcutaneous electrical stimulation (TES), a non-pharmacological approach, is postulated to facilitate bowel movement by modulating the nerves of the large bowel via the application of electrical current transmitted through the abdominal wall...
2016: Cochrane Database of Systematic Reviews
Jun Wei Wu, Yu Rong Xing, Yi Bo Wen, Tian Fang Li, Jia Feng Xie, Quan De Feng, Xiao Ping Shang, Yun Long Li, Jin Jin Feng, Xin Xin Wang, Rong Qun Zhai, Xiang Fei He, Tao Chen, Xin Jian Liu, Jian Guo Wen
PURPOSE: To investigate the prevalence of spina bifida occulta (SBO) and its relationship with the presence of overactive bladder (OAB) in middle-aged and elderly people in China. METHODS: A cross-sectional community-based survey was carried out at 7 communities in Zhengzhou City, China from December 15, 2013 to June 10, 2014, where residents aged over 40 years were randomly selected to participate. All of the participants underwent lumbosacral radiographic analysis and relevant laboratory tests...
June 2016: International Neurourology Journal
Filippo Parolini, Paolo Orizio, Anna Lavinia Bulotta, Miguel Garcia Magne, Giovanni Boroni, Gianpaolo Cengia, Fabio Torri, Daniele Alberti
Sigmoid volvulus (SV) is extremely uncommon in children and is usually associated with a long-standing history of constipation or pseudo-obstruction. An early diagnosis and management are crucial in order to prevent the appearance of hemorrhagic infarction of the twisted loop, avoiding further complications such as necrosis, perforation and sepsis. In patients with no evidence of peritonitis or ischemic bowel, treatment starts with resuscitation and detorsion of the SV, accomplished by means of sigmoidoscopy and concomitant rectal tube placement...
June 25, 2016: World Journal of Gastrointestinal Endoscopy
Anne J Wright, Mirna Haddad
Both non-invasive and invasive electroneurostimulation (ENS) modalities for bladder bowel dysfunction have been studied and reported in children. A summary of the proposed mechanism of actions and the more commonly used and recently reported techniques and outcomes are described. This includes transcutaneous electrical nerve stimulation, functional electrical nerve stimulation, intravesical electrical nerve stimulation, percutaneous tibial nerve stimulation and sacral neuromodulation in conditions including overactive bladder, enuresis, dysfunctional voiding, constipation, combined bladder bowel dysfunction and neuropathic bladder and bowel dysfunction...
May 27, 2016: European Journal of Paediatric Neurology: EJPN
M A Benninga, M M Tabbers, R R van Rijn
Defecation-related functional gastrointestinal disorders (FGIDs), such as infant dyschezia, functional constipation and functional non-retentive faecal incontinence, as defined by the Rome IV criteria, are common problems in childhood. The symptomatology varies from relatively mild, such as crying before passage of soft stools or infrequent defecation to severe problems with faecal impaction and the daily involuntary loss of faeces in the underwear. Conventional radiography is widely available, relatively cheap and is non-invasive...
August 2016: Archives of Disease in Childhood. Education and Practice Edition
Amol Bapaye, Gajanan Wagholikar, Sameer Jog, Aditi Kothurkar, Shefali Purandare, Nachiket Dubale, Rajendra Pujari, Mahesh Mahadik, Viral Vyas, Jay Bapaye
Hirschsprung's disease (HD) is a congenital disorder characterized by the absence of intrinsic ganglion cells in submucosal and myenteric plexuses of the hindgut; and presents with constipation, intestinal obstruction and/or megacolon. HD commonly involves the rectosigmoid region (short segment HD), although shorter and longer variants of the disease are described. Standard treatment involves pull-through surgery for short segment HD or posterior anorectal myotomy in selected ultrashort segment candidates. Third space endoscopy has evolved during the past few years...
September 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Saleh M Eftaiha, George Melich, Ajit Pai, Slawomir J Marecik, Leela M Prasad, John J Park
INTRODUCTION: Bowel dysfunction (fecal incontinence and constipation) presents in over 50% of patients after treatment of congenital anal malformations. Sacral nerve stimulation (SNS) for the treatment of fecal incontinence improves function in the majority of patients. We present a case report of the treatment of bowel dysfunction with sacral nerve stimulation in a patient with a history of an imperforate anus. PRESENTATION OF CASE: A twenty year-old female with a history of imperforate anus at birth, repaired during infancy with anorectoplasty, presented with fecal incontinence and constipation...
2016: International Journal of Surgery Case Reports
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