Functional constipation in children: What physicians should know

Area of Science:

• Pediatrics
• Gastroenterology
• Pharmacology

Background:

• Functional constipation (FC) is the most prevalent functional gastrointestinal disorder in children, with a global prevalence of 14.4% based on Rome IV criteria.
• Its multifactorial pathophysiology complicates management, with osmotic laxatives and toilet training being the primary treatments.
• Treatment failure is often linked to children's medication adherence and parental concerns about long-term laxative use.

Purpose of the Study:

• To provide a comprehensive overview of functional constipation in children.
• To review global prevalence, pathogenesis, diagnostic criteria, and management strategies for pediatric FC.
• To explore both conventional and emerging therapeutic options for functional constipation.

Main Methods:

• Systematic review of existing literature on pediatric functional constipation.
• Analysis of diagnostic criteria, including Rome IV criteria.
• Evaluation of pharmacological and non-pharmacological treatment options, including novel therapies.

Main Results:

• Osmotic laxatives, alongside toilet training, are the current mainstay treatment for pediatric functional constipation.
• Novel therapies including probiotics, synbiotics, and specific receptor agonists show promise but require further research.
• Non-pharmacological approaches like dietary changes and physiotherapy are important, with surgery reserved for refractory cases.

Conclusions:

• Functional constipation is a common childhood disorder requiring multifaceted management approaches.
• Adherence and parental concerns are key challenges in current treatment paradigms.
• Further research into novel therapies and personalized treatment strategies is crucial for improving outcomes in pediatric functional constipation.