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Constipation in children

Merit M Tabbers1, Nicole Boluyt, Marjolein Y Berger

  • 1Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.

BMJ Clinical Evidence
|July 2, 2011
PubMed

Insights

This systematic review evaluates treatments for childhood constipation and fecal impaction. It found various interventions, including laxatives and behavioral therapies, with evidence on their effectiveness and safety for pediatric patients.

Area of Science:

  • Pediatric Gastroenterology
  • Evidence-Based Medicine
  • Systematic Review Methodology

Background:

  • Childhood constipation affects 0.7%–29.6% globally, often without clear causes.
  • Chronic constipation persists into puberty for one-third of children.
  • Painful defecation and withholding behaviors are common in pediatric constipation and impaction.

Purpose of the Study:

  • To systematically review the effects of treatments for chronic constipation in children.
  • To assess treatments for bowel clearing in children with fecal impaction.

Main Methods:

  • Conducted a systematic review of medical literature up to August 2009.
  • Searched Medline, Embase, The Cochrane Library, and other databases.
  • Included randomized controlled trials (RCTs) and harms alerts from regulatory agencies.

Main Results:

  • Included 14 systematic reviews and RCTs meeting the inclusion criteria.
  • Performed a GRADE evaluation to assess the quality of evidence for interventions.
  • Analyzed a wide range of interventions for pediatric constipation.

Conclusions:

  • Presents information on the effectiveness and safety of numerous interventions.
  • Interventions reviewed include anal dilatation, behavioral treatments, laxatives, fiber, and surgical disimpaction.
  • Provides a comprehensive overview to guide clinical practice in pediatric constipation management.
Abstract

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