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Functional Constipation in Children

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Pediatric Neurogastroenterology

Abstract

Childhood constipation is a common pediatric healthcare problem. The diagnosis is based on history and physical examination, in accordance with the pediatric diagnostic Rome III criteria. Additional investigations are only indicated if the diagnosis is not clear or in order to rule out an underlying organic disease. Non-pharmacological management involves education, demystification, a toilet program with reward system, and a daily bowel diary. Pharmacological treatment with laxatives consists of disimpaction, maintenance treatment, and weaning of medication. Polyethylene glycol (PEG) is the treatment of first choice for both disimpaction and maintenance treatment. If PEG is not available or poorly tolerated, lactulose is recommended. Other laxatives are available as second-line or additional treatment if treatment with PEG is insufficient. In children with intractable symptoms surgery can be considered, but there are no clear guidelines for surgical management due to a lack of evidence.

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Authors and Affiliations

  1. Department of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital/Academic Medical Center, Amsterdam, The Netherlands

    Ilan J. N. Koppen M.D.

  2. Department of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital/Academic Medical Center, H7-248, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Marc A. Benninga M.D., Ph.D.

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  1. Ilan J. N. Koppen M.D.
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  2. Marc A. Benninga M.D., Ph.D.
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Correspondence to Marc A. Benninga M.D., Ph.D. .

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Editors and Affiliations

  1. Division of Pediatric Gastroenterology Hepatology and Nutrition, CHU Sainte-Justine, Montreal, Québec, Canada

    Christophe Faure

  2. Department of Paediatric Gastroenterology, UCL Institute of Child Health, London, United Kingdom

    Nikhil Thapar

  3. Division of Pediatric Gastroenterology Hepatology, and Nutrition, Nationwide Children’s Hospital, Columbus, Ohio, USA

    Carlo Di Lorenzo

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Koppen, I.J.N., Benninga, M.A. (2017). Functional Constipation in Children. In: Faure, C., Thapar, N., Di Lorenzo, C. (eds) Pediatric Neurogastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-319-43268-7_42

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  • DOI: https://doi.org/10.1007/978-3-319-43268-7_42

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