Related Experiment Videos
[Constipation in children]
1Servizio Speciale di Gastroenterologia, Istituto di Clinica Pediatrica, Policlinico Umberto I di Roma, Università La Sapienza, Roma, Italia.
Insights
Pediatric constipation, often functional, can stem from diet or cow
Area of Science:
- Pediatric Gastroenterology
- Digestive Health
- Clinical Pediatrics
Context:
- Constipation affects 0.3–8% of pediatric patients, rising to 10–25% in gastroenterology settings.
- Functional constipation, prevalent in 90–95% of cases, is linked to diet (e.g., low fiber, exclusive milk) or cow's milk protein intolerance.
- Organic causes like Hirshsprung disease, anorectal malformations, and intestinal atresia/stenosis are significant in newborns.
Purpose:
- To review the causes, diagnosis, and management of constipation in pediatric patients.
- To highlight the role of diet and cow's milk protein intolerance in pediatric constipation.
- To discuss diagnostic tools and therapeutic strategies for persistent constipation.
Summary:
- Functional constipation is common, often diet-related. Cow's milk protein intolerance can cause inflammation and constipation, resolving with a milk-free diet.
- Diagnostic methods for persistent cases include total intestinal transit time (TITT), anorectal manometry, electromyography, and defecography.
- Over 90% of cases resolve with dietary changes, laxatives, suppositories, enemas, or psychological support. Low-dose polyethylene glycol (PEG) shows promise for chronic functional constipation.
Impact:
- Provides a comprehensive overview for clinicians managing pediatric constipation.
- Emphasizes non-invasive and dietary interventions as first-line treatments.
- Supports the use of polyethylene glycol (PEG) as an effective treatment for chronic functional constipation.
Abstract:
Constipation is a common disease in paediatric age, with an incidence ranging from 0.3 to 8% in paediatric patients, and from 10 to 25% among paediatric gastroenterological patients. In 90-95% of cases constipation is a functional, and often due to an exclusively milky diet or, in advanced age, to an inadequate fibres intake. Among the organic forms causing constipation, especially in new-born age, Hirshsprung disease, anorectal malformations, intestinal atresiae and stenosis are frequent. Moreover, recent studies have shown that constipation is often the symptom of a cow's milk proteins intolerance, that leadis to colorectal mucosa inflammation, with peristalsis decrease and fecal slackness. In these patients a milk's proteins free diet recovers constipation. In most persistent forms, total intestinal transit time (TITT), anorectal manometry, sphynteric muscles electromyografy and defecofraphy are useful to the diagnosis. In more than 90% of cases simple diet revisions, fecal softening, evacuative suppositories and enemas recovers constipation, some times a psychological approach is useful. Furthermore, excellent results can be obtained by giving low doses of polietiltnglycol (PEG), which has been recently introduced for the treatment of functional chronic constipation.