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Functional constipation in children: a systematic review on prognosis and predictive factors
M A M Pijpers1, M E J Bongers, M A Benninga
1Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands.
Journal of Pediatric Gastroenterology and Nutrition
|February 2, 2010
Summary
Most children with functional constipation recover within a year, with about 60% symptom-free. Defecation frequency and family history do not predict recovery in childhood constipation.
Area of Science:
- Pediatric Gastroenterology
- Clinical Epidemiology
Background:
- Accurate prognosis and identification of predictive factors for childhood functional constipation are crucial for patient counseling and treatment strategy.
- Understanding these factors aids in identifying children at high risk for unfavorable outcomes.
Purpose of the Study:
- To systematically review and synthesize the evidence on the prognosis of childhood functional constipation.
- To identify factors that predict the clinical course and outcome of functional constipation in children.
Main Methods:
- A comprehensive literature search was conducted in MEDLINE and Embase for prospective follow-up studies on childhood functional constipation.
- Methodological quality was assessed, and results on prognosis were pooled; prognostic factors were summarized using a best evidence synthesis.
Main Results:
- Out of 2882 abstracts, only 14 studies met inclusion criteria, with significant heterogeneity and only 21% scoring high in methodological quality.
- Approximately 49% of children recovered and were weaned off laxatives within 6-12 months; 60.6% were symptom-free.
- Defecation frequency and a positive family history were not associated with recovery.
Conclusions:
- The existing literature on childhood functional constipation prognosis is limited, characterized by heterogeneity and poor methodological quality.
- A significant majority of children experience symptom resolution within a year, irrespective of defecation frequency or family history.
- Currently, it is not possible to identify specific subgroups of children at high risk for a poor prognosis based on available evidence.
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