Purpose of review
Functional constipation (FC) is a disorder of multifactorial origin that accounts for the vast majority of constipation cases in children and often leads to a significant impact on quality of life. Functional constipation can be challenging to manage due to its mixed etiology. Understanding epidemiologic and physiologic features in the process of defecation is key when choosing an adequate diagnostic and management plan for patients with functional constipation.
There is a wide range of pharmacologic treatments that can be implemented at initial diagnosis; however, results can significantly vary and sometimes lead to a chronic disease state. At this point, non-pharmacologic or interventional methods can be applied in order to restore a physiologic defecation pattern. This review describes the epidemiology and pathophysiology of FC in addition to current pharmacologic, interventional and complementary treatment options within the pediatric population.
FC is a common problem within the pediatric population that must be studied more extensively to better understand its physiology and appropriate treatment. Although many children with FC respond to conventional treatment methods, it is especially important to gain a more thorough understanding of treatment options for children with refractory constipation.
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• Lu PL, Koppen IJN, Orsagh-Yentis DK, et al. Sacral nerve stimulation for constipation and fecal incontinence in children: Long-term outcomes, patient benefit, and parent satisfaction. Neurogastroenterol Motil. 2018;30:e13184. https://doi.org/10.1111/nmo.13184. Reported that children with FC who received SNS reported significant improvement in symptoms and quality of life. Additionally, this study provided follow-up data on patients that echoed significant improvement in symtpoms with significantly decreased episodes of fecal incontinence.
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Mousa, H.M., Barsamian, J.M., Benitez, A.J. et al. Pediatric Constipation: an Epidemiologic and Physiologic Approach to Guide a Stepwise Approach to its Management. Curr Treat Options Peds (2020). https://doi.org/10.1007/s40746-020-00199-z
- Fecal incontinence
- Defecation disorder
- Advanced therapy
- Complementary care