Chronic Constipation in Pediatrics: Pathophysiology and Diagnosis

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Ano-Rectal Endosonography and Manometry in Paediatrics

Abstract

Constipation is one of the most common gastrointestinal symptoms in children. Chronic constipation is defined when symptoms are present for more than 3 months. The key feature required for the diagnosis is reduced stool frequency, which must be evaluated comparing with age-related normal patterns of defecation frequency. The two main causes of chronic constipation in children are functional constipation and organic disease. History and physical examination should be able to recognize the few children who are at risk of having a serious disorder and that must undergo additional studies.

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References

  1. Tabbers MM, DiLorenzo C, Berger MY, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; North American Society for Pediatric Gastroenterology. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 2014 Feb;58(2):258–74.

    Article  CAS  Google Scholar 

  2. van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol. 2006;101:2401.

    Article  Google Scholar 

  3. Robin SG, Keller C, Zwiener R, et al. Prevalence of pediatric functional gastrointestinal disorders utilizing the Rome IV criteria. J Pediatr. 2018;195:134.

    Article  Google Scholar 

  4. Mugie SM, Benninga MA, Di Lorenzo C. Epidemiology of constipation in children and adults: a systematic review. Best Pract Res Clin Gastroenterol. 2011;25:3–18.

    Article  Google Scholar 

  5. Benninga MA, Faure C, Hyman PE, et al. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology. 2016:S0016-5085(16)00182-7. https://doi.org/10.1053/j.gastro.2016.02.016.

  6. Hyams JS, Di Lorenzo C, Saps M, et al. Functional disorders: children and adolescents. Gastroenterology. 2016:S0016-5085(16)00181-5.

    Google Scholar 

  7. de Moraes JG, Motta ME, Beltrão et al. Fecal microbiota and diet of children with chronic constipation. Int J Pediatr 2016;2016:6787269.

    Google Scholar 

  8. Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology. 2016:S0016-5085(16)00223.

    Google Scholar 

  9. Rubin GP. Childhood constipation. Am Fam Physician. 2003;67:1041.

    PubMed  Google Scholar 

  10. Loening-Baucke V. Chronic constipation in children. Gastroenterology. 1993;105:1557.

    Article  CAS  Google Scholar 

  11. Loening-Baucke V. Prevalence, symptoms and outcome of constipation in infants and toddlers. J Pediatr. 2005;146:359.

    Article  Google Scholar 

  12. Di Lorenzo C. Pediatric anorectal disorders. Gastroenterol Clin N Am. 2001;30:269.

    Article  Google Scholar 

  13. Fontana M, Bianchi C, Cataldo F, et al. Bowel frequency in healthy children. Acta Paediatr Scand. 1989;78:682.

    Article  CAS  Google Scholar 

  14. Hyams JS, Treem WR, Etienne NL, et al. Effect of infant formula on stool characteristics of young infants. Pediatrics. 1995;95:50.

    Article  CAS  Google Scholar 

  15. den Hertog J, van Leengoed E, Kolk F, et al. The defecation pattern of healthy term infants up to the age of 3 months. Arch Dis Child Fetal Neonatal Ed. 2012;97:F465.

    Article  Google Scholar 

  16. Arce DA, Ermocilla CA, Costa H. Evaluation of constipation. Am Fam Physician. 2002;65:2283.

    PubMed  Google Scholar 

  17. Iacono G, Cavataio F, Montalto G, et al. Intolerance of cow’s milk and chronic constipation in children. N Engl J Med. 1998;339:1100.

    Article  CAS  Google Scholar 

  18. Leung AK, Chan PY, Cho HY. Constipation in children. Am Fam Physician. 1996;54:611.

    CAS  PubMed  Google Scholar 

  19. Hendren WH. Pediatric rectal and perineal problems. Pediatr Clin N Am. 1998;45:1353.

    Article  CAS  Google Scholar 

  20. Abi-Hanna A, Lake AM. Constipation and encopresis in childhood. Pediatr Rev. 1998;19:23.

    Article  CAS  Google Scholar 

  21. Hellerstein S, Linebarger JS. Voiding dysfunction in pediatric patients. Clin Pediatr (Phila). 2003;42:43.

    Article  Google Scholar 

  22. Loening-Baucke V. Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood. Pediatrics. 1997;100:228.

    Article  CAS  Google Scholar 

  23. van Summeren JJGT, Holtman GA, van Ommeren SC, et al. Bladder symptoms in children with functional constipation: a systematic review. J Pediatr Gastroenterol Nutr. 2018;67:552.

    Article  Google Scholar 

  24. Rosen R, Buonomo C, Andrade R, Nurko S. Incidence of spinal cord lesions in patients with intractable constipation. J Pediatr. 2004;145:409.

    Article  Google Scholar 

  25. Siddiqui A, Rosen R, Nurko S. Anorectal manometry may identify children with spinal cord lesions. J Pediatr Gastroenterol Nutr. 2011;53:507.

    Article  Google Scholar 

  26. Tambucci R, Quitadamo P, Thapar N, et al. Diagnostic tests in pediatric constipation. J Pediatr Gastroenterol Nutr. 2018;66(4):e89–98.

    Article  Google Scholar 

  27. Hussain SZ, Di Lorenzo C. Motility disorders. Diagnosis and treatment for the pediatric patient. Pediatr Clin N Am. 2002;49(27)

    Google Scholar 

  28. Osatakul S, Patrapinyokul S, Osatakul N. The diagnostic value of anorectal manometry as a screening test for Hirschsprung’s disease. J Med Assoc Thail. 1999;82:1100.

    CAS  Google Scholar 

  29. Pensabene L, Youssef NN, Griffiths JM, Di Lorenzo C. Colonic manometry in children with defecatory disorders. Role in diagnosis and management. Am J Gastroenterol. 2003;98(1052)

    Google Scholar 

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Correspondence to Andrea Pession .

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Pession, A., Leardini, D., Muratore, E., Masetti, R. (2022). Chronic Constipation in Pediatrics: Pathophysiology and Diagnosis. In: Lima, M., Ruggeri, G. (eds) Ano-Rectal Endosonography and Manometry in Paediatrics. Springer, Cham. https://doi.org/10.1007/978-3-030-97668-2_10

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  • DOI: https://doi.org/10.1007/978-3-030-97668-2_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-97667-5

  • Online ISBN: 978-3-030-97668-2

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