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  • Review Article
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Constipation in childhood

Nature Reviews Gastroenterology & Hepatology volume 8, pages 502–511 (2011)Cite this article

Subjects

Abstract

Constipation in children is an often long-lasting pediatric functional gastrointestinal disorder with a worldwide prevalence varying between 0.7% and 29.6%, and estimated health-care costs of US$3.9 billion per year in the USA alone. The pathophysiology of childhood constipation is multifactorial and remains incompletely understood; however, withholding of stools, starting after an experience of a hard, painful, or frightening bowel movement is the most common cause found in children. A thorough medical history and physical examination, including a rectal examination in combination with a bowel diary, is sufficient in the majority of cases to diagnose constipation. The current standard treatment consists of education, toilet training, disimpaction, maintenance therapy and long-term follow-up. In the past decade, well-designed treatment trials in the pediatric population have emerged and long-term outcome studies have been completed. This Review summarizes the current knowledge of the clinical aspects of childhood constipation, including pathogenesis, diagnosis and treatment, with particular emphasis on the latest available data.

Key Points

  • 0.7–29.6% of children in all pediatric age groups have functional constipation

  • No other diagnostic tests besides a thorough medical history and physical examination are usually necessary to diagnose functional constipation

  • Current recommended treatment consists of a combination of education, medical treatment and close follow-up

  • Little evidence exists that dietary interventions, including high fluid intake, fiber, prebiotics and probiotics, are effective in the treatment of childhood constipation

  • Intensive follow-up is necessary as 50% of children with constipation still have defecatory problems after 5 years of treatment

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Authors and Affiliations

  1. Emma Children's Hospital, Amsterdam Medical Center, Meigbergdreef 9, Amsterdam, 1105, AZ, The Netherlands

    Suzanne M. Mugie & Marc A. Benninga

  2. Department of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, 700 Children's Drive, Columbus, 43205, OH, USA

    Carlo Di Lorenzo

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Mugie, S., Di Lorenzo, C. & Benninga, M. Constipation in childhood. Nat Rev Gastroenterol Hepatol 8, 502–511 (2011). https://doi.org/10.1038/nrgastro.2011.130

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