Chronic Refractory Constipation in Children: Think Beyond Stools

Area of Science:

• Pediatric Gastroenterology
• Clinical Therapeutics

Background:

• Chronic refractory constipation (CRC) affects children resistant to maximum laxative therapy.
• Referral is common for refractory constipation due to underlying diseases or ineffective treatments.

Purpose of the Study:

• To present treatment options for children with refractory constipation.
• To review pharmacological and non-pharmacological management modalities.
• To provide an algorithm for managing refractory constipation in pediatric patients.

Main Methods:

• Review of pharmacological treatment options.
• Review of non-pharmacological treatment modalities.
• Development of a management algorithm.

Main Results:

• Most constipated children respond to conventional medical therapies.
• A subset of children with constipation does not benefit from standard treatments.
• Further evaluation is recommended for treatment failures or suspected organic disease.

Conclusions:

• Effective management strategies exist for refractory constipation in children.
• A systematic approach, including pharmacological and non-pharmacological methods, is crucial.
• An algorithmic approach can guide clinicians in treating resistant cases.