Materiały źródłowe

• #1 Constipation in Children: Novel Insight Into Epidemiology, Pathophysiology and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3042216/

  Constipation in children is a common health problem affecting 0.7% to 29.6% children across the world. […] Global burden of childhood constipation is often underappreciated. This was mainly due to lack of data in this age group. In epidemiological studies, the definitions vary from accepted Rome criteria to proxy reports by parents. A recent systematic review in pediatric age group reported constipation in 0.7% to 29.6%. […] A survey in Sri Lanka using Rome III criteria reported constipation in 10.6% of 10-16 years old. Similarly, prevalence of constipation in Japan was 18.5%. […] The available data indicate that constipation is on the rise. A recent analysis of longitudinal data in the USA beginning from 1979 showed nearly 4-fold increase in rates of constipation during the last decade. […] All these facts prove that constipation is a growing health problem among children worldwide.

• #2 Epidemiology of constipation in children and adults: a systematic review – PubMed

  https://pubmed.ncbi.nlm.nih.gov/21382575/

  We aimed to review the published literature regarding the epidemiology of constipation in the general paediatric and adult population and to assess its geographic, gender and age distribution, and associated factors. […] The epidemiology of constipation in children was investigated in 19 articles and prevalence rate was between 0.7% and 29.6% (median 12%). Female gender, increasing age, socioeconomic status and educational level seemed to affect constipation prevalence.

• #3

  https://journals.lww.com/ajg/fulltext/2006/10000/epidemiology_of_childhood_constipation__a.32.aspx

  A systematic review of the published literature was performed to assess the prevalence, incidence, natural history, and comorbid conditions of functional constipation in children. […] Eighteen studies met our inclusion criteria. The prevalence of childhood constipation in the general population ranged from 0.7% to 29.6% (median 8.9; inter quartile range 5.317.4). […] Childhood constipation is a common problem worldwide. Most studies report similar prevalence rates for boys and girls. Large epidemiologic studies with the use of generally accepted diagnostic criteria are needed to define the precise prevalence of constipation.

• #4 Functional constipation in children: What physicians should know

  https://www.wjgnet.com/1007-9327/full/v29/i8/1261

  Functional constipation (FC) is considered the most common functional gastrointestinal disorder in children with a pooled global prevalence of 14.4% (95% confidence interval: 11.2-17.6) when diagnosed based on the Rome IV criteria. […] Globally, up to 25% of visits to pediatric gastroenterologists and 3% of all general pediatric outpatient visits are due to FC. It is difficult to determine the true prevalence of FC in children due to the heterogeneity of the studies in terms of target population sampling, diagnostic criteria, participant ethnicity and environment, method of data acquisition, and life style and psychological factors among others. […] A systematic review and meta-analysis published by Koppen et al reported that the worldwide prevalence of FC according to the Rome III criteria was 9.5% [95% confidence interval (CI): 7.5%-12.1%], with significantly more American and European children being affected than Asian ones. Additionally, geographical region, diet, and exposure to traumatic life events were linked to FC in children.

• #5 Functional constipation in children: What physicians should know

  https://www.wjgnet.com/1007-9327/full/v29/i8/1261.htm

  Functional constipation (FC) is considered the most common functional gastrointestinal disorder in children with a pooled global prevalence of 14.4% (95% confidence interval: 11.2-17.6) when diagnosed based on the Rome IV criteria. […] Globally, up to 25% of visits to pediatric gastroenterologists and 3% of all general pediatric outpatient visits are due to FC. […] A systematic review and meta-analysis published by Koppen et al reported that the worldwide prevalence of FC according to the Rome III criteria was 9.5% [95% confidence interval (CI): 7.5%-12.1%], with significantly more American and European children being affected than Asian ones. […] We determined that the pool global prevalence of FC in children was 14.4% (95%CI: 11.2-17.6) using the Rome IV criteria. According to continent, Africa had a highest prevalence of constipation (31.4%), followed by America (12.1%, 95%CI: 9.1%-15.1%), Europe (8.3%, 95%CI: 3.7%-12.9%), and Asia (6.2%, 95%CI: 1.3-11). […] The primary reasons for the global diversity in prevalence among published studies may be due to the lack of agreement on diagnostic standards and cultural differences.

• #6 Functional constipation in children: What physicians should know

  https://www.wjgnet.com/1007-9327/full/v29/i8/1261

  We determined that the pool global prevalence of FC in children was 14.4% (95%CI: 11.2-17.6) using the Rome IV criteria. According to continent, Africa had a highest prevalence of constipation (31.4%), followed by America (12.1%, 95%CI: 9.1%-15.1%), Europe (8.3%, 95%CI: 3.7%-12.9%), and Asia (6.2%, 95%CI: 1.3-11). […] The primary reasons for the global diversity in prevalence among published studied may be due to the lack of agreement on diagnostic standards and cultural differences.

• #7 Constipation in Children: Novel Insight Into Epidemiology, Pathophysiology and Management

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm.2011.17.1.35

  Constipation in Children: Novel Insight Into Epidemiology, Pathophysiology and Management […] Global burden of childhood constipation is often underappreciated. This was mainly due to lack of data in this age group. In epidemiological studies, the definitions vary from accepted Rome criteria to proxy reports by parents. A recent systematic review in pediatric age group reported constipation in 0.7% to 29.6%. […] Until recently, it was believed that constipation is a disease of the developed world, but studies from Asia have reported equally high prevalence of constipation. A survey in Sri Lanka using Rome III criteria reported constipation in 10.6% of 10-16 years old. Similarly, prevalence of constipation in Japan was 18.5%. […] The available data indicate that constipation is on the rise. A recent analysis of longitudinal data in the USA beginning from 1979 showed nearly 4-fold increase in rates of constipation during the last decade. There was a surge in both outpatient clinic visits and hospitalizations due to constipation between 1992 and 2004, with more than a doubling of rates in diagnosing constipation from outpatient clinics and nearly 4-fold increase in rates of hospital discharge under the diagnosis of constipation. Furthermore, children under 15 years had the highest number of clinic visits for constipation. […] All these facts prove that constipation is a growing health problem among children worldwide.

• #8 (PDF) Epidemiology, Demographic Profile and Clinical Variability of Functional Constipation: A Retrospective Study in North Bihar

  https://www.academia.edu/124908084/Epidemiology_Demographic_Profile_and_Clinical_Variability_of_Functional_Constipation_A_Retrospective_Study_in_North_Bihar

  The first concrete scientific-based diagnostic criteria for FC was released in 1999 as Rome II criteria. […] Constipation was thought to be a disease of the Western world for many decades. However, one of the first few epidemiological research in Sri Lanka noted a prevalence of 15.4%, indicating the gross underestimation of the prevalence of FC in developing countries. […] In addition, the first epidemiological survey from Nigeria found a prevalence of 27%, confirming a high disease burden in the developing world, indicating that childhood constipation is not a disease of the western hemisphere but a global health problem across all socioeconomic strata. […] Several risk factors are known to associate with FC in children. Poor toilet training is the commonest cause for FC in young children.

• #9 Bowel Movement Patterns and Constipation Prevalence in School Children of South Jordan | Altamimi | International Journal of Clinical Pediatrics

  https://www.theijcp.org/index.php/ijcp/article/view/318/264

  Pediatric constipation is a common problem worldwide. […] This study aimed to investigate bowel motion pattern and constipation prevalence in Jordanian children using self-reporting. […] In our cohort, 110 (26.6%) children met Rome III criteria for constipation, which was not statistically significant by sex. […] Constipation affects approximately 25% of Jordanian school children between 11 and 16 years old. […] Failure to recognize constipation in school children may lead to delayed treatment and has been associated with complications (e.g. fecal incontinence) and poorer long-term outcomes (e.g. persistence of symptoms and continuous need for laxatives). […] In our cohort, 20.1% of children reported having fecal incontinence at least once per month, which is a higher percentage than previously reported among school children. […] In our cohort, 110 (26.6%) participants met the criteria for constipation, which is also consistent with a previous Brazilian study. […] Most Jordanian school children have a daily soft bowel movement without pain or retention.

• #10 Epidemiology of Paediatric constipation in Indonesia and its association with exposure to stressful life events | springermedizin.de

  https://www.springermedizin.de/epidemiology-of-paediatric-constipation-in-indonesia-and-its-ass/16170086

  We aimed to study the epidemiology and risk factors, including exposure to emotional stress, for constipation in Indonesian children and adolescents of 1017 year age group. […] Of 1796 children included in the analysis, 328 (18.3%; 95% CI 0160.2) had constipation. […] Constipation in children and adolescent is a significant health problem, affecting almost 20% of Indonesian school-age children and adolescents. […] Childhood constipation is considered to be an emerging global public health problem. The prevalence varies among countries from 0.7 to 29.6%. […] The aetiology of constipation in children and young adults is not clear. […] Studies suggest that psychological stress, childhood maltreatment and abnormal childhood personality traits such as hostility, aggression, and negative self-esteem, are associated with functional constipation in children.

• #11 Pediatric Constipation: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/928185-overview

  Constipation occurs in all pediatric age groups from infancy to young adulthood. Typically, childhood constipation develops during 3 stages of childhood: in infants during weaning, in toddlers during toilet training, and in school-aged children. In several published reports, approximately half of childhood constipation occurs during the first year of life. […] Before puberty, constipation appears to be equally common among girls and boys. After puberty and into young adulthood, females are more likely to develop constipation than males.

• #12 Pediatric Functional Constipation in Clinical Practice: The Continuous Search for the Light at the End of the Tunnel

  https://www.scientificarchives.com/article/pediatric-functional-constipation-in-clinical-practice-the-continuous-search-for-the-light-at-the-end-of-the-tunnel

  FC reputable epidemiological studies were developed along this path. In 2006, a systematic review, including eighteen studies, showed that the prevalence of FC in children from 0 to 18 years ranged from 0.7% to 29.6% (median 8.9%), considered a worldwide common problem. In 2011, the same authors, now including adults, evaluated the epidemiology of FC in 19 articles, and the prevalence rate was between 0.7% and 29.6% (median 12%). Females, increasing age, socioeconomic status, and educational level affected the prevalence of constipation. […] In 2018, a systematic review and meta-analysis including 35 countries defined a pooled prevalence of 9.5%, with a similar prevalence in boys (8.6%) and girls (8.9%) but with a higher prevalence of 17.5% in children under four years. A systematic review of pediatric functional gastrointestinal disorders, based on Rome IV Criteria, recently included 20 papers in the final analysis. FC was the most common pediatric functional gastrointestinal disorder for children aged 13-48 months and for those over four years. Accordingly, there is a tendency for the median to stabilize around 10% over time.

• #13 Childhood constipation

  https://www.racgp.org.au/afp/2017/december/childhood-constipation

  Constipation is best defined as difficulty passing stools that may be infrequent (2 per week), painful and associated with stool retention. Childhood constipation is common, with a prevalence of 330% worldwide. […] Constipation is a common problem in childhood, affecting an estimated 3% of children worldwide and up to 30% in some settings. […] Childhood functional constipation is best described using the Rome IV criteria and is defined by the presence of two or more of the following features for at least one month: 2 stools per week, excessive stool retention, painful or hard bowel movements, presence of large faecal mass in rectum, history of large diameter bulky stools, 1 episode per week of faecal incontinence after toilet training completed. […] While the median age for onset of functional constipation is 2.3 years, common times for constipation to arise include transition to solids, toilet training and school entry. […] If there are ongoing symptoms of constipation after six months of appropriate treatment, a referral for specialist care and a second opinion is warranted.

• #14

  https://www.ijpediatrics.com/index.php/ijcp/article/view/3387

  Constipation is a common problem throughout childhood. It is important to be fully aware of the factors involved in developing constipation in children. There are few published articles on childhood constipation in Bangladesh. In this study, our aim was to evaluate demography and probable/potential risk factors for functional constipation in Bangladeshi children. […] A total of 179 subjects were included in the final analysis. Among them, 54.75% were boys and 45.25% were girls. Constipation was found more in the age group above 5 years (56.42%), then in 2 to 5 years age group (33.52%) and lower in below 2 years of age (10.6%). Constipation was more among children living in urban area (55.3%) than in rural area (44.69%). […] Functional constipation was found more in boys and above five year age group. Low dietary fiber, consumption of cows milk and junk food, unwillingness to use toilets in school, long time in academic activity, were found to be potential underlying risk factors of constipation.

• #15 (PDF) Epidemiology, Demographic Profile and Clinical Variability of Functional Constipation: A Retrospective Study in North Bihar

  https://www.academia.edu/124908084/Epidemiology_Demographic_Profile_and_Clinical_Variability_of_Functional_Constipation_A_Retrospective_Study_in_North_Bihar

  Constipation is a worldwide problem. Current research aimed to study the various determinants of functional constipation and clinical spectrum in north Bihar. […] Total 892 children were examined during the study period, of which 343 children were diagnosed to have constipation. Among them 315 (35.31%) children were qualified to have functional constipation as per ROME 3 criteria. […] Females were more affected (61.58%) than males. Maximum cases were between 2-5 yrs (62.2%), lower socioeconomic status (56.19%) and rural background (50.15%). […] Constipation causes physical, psychological morbidity and poor quality of life, hence early diagnosis and management is of utmost importance. […] Functional constipation (FC) is a common problem in the world. The estimated global prevalence is 9.5%.

• #16 Functional constipation in infancy and early childhood: epidemiology, risk factors, and healthcare consultation | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-019-1652-y

  Functional constipation (FC) is a pediatric problem that is seen frequently. However, its prevalence in Asia remains undetermined. In this study we attempted to determine the prevalence, risk factors and therapeutic modalities of FC in infants and toddlers in Sri Lanka. […] A total of 1113 children were analyzed [(female n=560 (50.3%) with a mean age of 20.7months, standard deviation [SD] 11.2months. FC was found in 89 (8.0%). FC was significantly and independently associated with underweight (14.3% vs 7.2%,p=0.008. [OR and 95% CI: 2,3 (CI; 1.34.2)] and residence in an urban area (9.6% vs 5.6%,p=0.013). [OR and 95% CI: 0.592 (CI; 0.3960.95)]. Children subjected to violence showed a significantly higher prevalence of FC (20.0 vs 7.8%,p=0.046). […] FC occurred in 8% of this cohort of Sri Lankan infants and toddlers. It is significantly associated with underweight and living in an urban area. Only a quarter of them received medical attention for their constipation.

• #17 (PDF) Epidemiology, Demographic Profile and Clinical Variability of Functional Constipation: A Retrospective Study in North Bihar

  https://www.academia.edu/124908084/Epidemiology_Demographic_Profile_and_Clinical_Variability_of_Functional_Constipation_A_Retrospective_Study_in_North_Bihar

  Constipation is not uncommon in childhood. […] This study was aimed to evaluate demography and probable/potential risk factors for functional constipation in Bangladeshi children. […] Among potential risk factors, low fiber in diet (72.63%) was most common, other factors were ingestion of cows milk (32.96%), not having regular meals with parents (19.55%), consumption of junk foods (28.49%). […] Functional constipation is a common bowel disorder in the community which affects one in six children. The overall prevalence of constipation was 14.7% and 4.6% for FC while only 1.8% of respondents reported laxative use every day. […] Chronic constipation is a significant problem, affecting approximately 10% of children in a semi-urban school in Gampaha district. […] Chronic constipation is an important component of clinical gastroenterology practice worldwide. Based on the definition, either self-reported or using Rome criteria, chronic constipation can affect from 2% to 27% of the population.

• #18 Relationship between psychological stress with functional constipation in children: a systematic review

  https://www.panafrican-med-journal.com/content/article/46/8/full/

  constipation affects up to 29.6% of children worldwide, making it one of the most common gastrointestinal illnesses in the pediatric population. […] Majority of the studies showed a significant relationship between psychological stress and constipation in children. […] psychological stress and burden are associated to constipation in children. […] We classify psychological stressors in children into five broad spectrums, family-related stressors, school-related stressors, exposure to stressful life events, stress related to psychological disorders, and other factors. […] Based on this systematic review, we can conclude that stress and psychological burden are associated with constipation in children.

• #19 Anxiety Disorders in Children with Functional Constipation: A Case-Control Study

  https://brieflands.com/articles/jcp-119997

  Functional constipation (FC), as a prevalent condition in children, is estimated to have a 9.5% prevalence rate worldwide (1). […] FC puts a heavy burden on children and their parents (7), and this condition is associated with a decrease in quality of life, decreased academic performance, and psychological disorders including depression, aggression, emotional reactivity, and anxiety (7, 8). […] The findings revealed that anxiety was higher in children with FC than children without FC as the control group. Of the concerned indices, separation anxiety, generalized anxiety, and OCD were significantly different in the two groups, and they were significantly higher in the case group than the control group. […] Our study showed an association between anxiety disorders and FC. Accordingly, anxiety was higher in children with FC than children without FC as the control group. Of these indices, separation anxiety, general anxiety, and OCD were significantly different in the two groups.

• #20 Epidemiology of Paediatric constipation in Indonesia and its association with exposure to stressful life events | springermedizin.de

  https://www.springermedizin.de/epidemiology-of-paediatric-constipation-in-indonesia-and-its-ass/16170086

  A few studies in Asia have shown that the prevalence of childhood constipation vary between 0.3% in Japan to 32.2% in Taiwan. […] However, there is still a dearth of studies and information to fully understand the clinical epidemiology of this important health problem in Asia. […] Nearly one fifth (18.3%) of Indonesian school children and adolescents aged 1017 years fulfil the Rome III criteria for constipation. […] The prevalence rate of constipation in Indonesia (18.3%) is slightly higher than most of the studies from the Western world, South-East Asia, and South America. […] In contrast, the prevalence rate of constipation in Taiwan (32.2%) was nearly twice as high as in the current study. […] In our study, fathers alcoholism, severe illness in a close family member, hospitalization of the child for another illness, being bullied at school and loss of a parents job were clearly associated with constipation. […] Our findings have noteworthy implications both at national and global levels for clinical and research practices.

• #21 Evaluation and Treatment of Constipation in Children and Adolescents | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0715/p82.html

  Childhood constipation is common and almost always functional without an organic etiology. […] Constipation is one of the most common chronic disorders of childhood, affecting 1% to 30% of children worldwide. […] Constipation is responsible for 3% of all primary care visits for children and 10% to 25% of pediatric gastroenterology visits. […] Children with constipation cost the health care system three times as much as children without constipation, and the negative effect on quality of life often persists into adulthood. […] Most children with functional constipation require prolonged treatment and have frequent relapses. Studies have shown that only 60% of children with constipation achieve treatment success after one year of therapy. Children with fecal incontinence or who are younger than four years at onset of constipation are particularly at risk of poor long-term outcomes. […] Referral to a pediatric gastroenterologist may be needed when a child with constipation has red flags for organic disease or the constipation is unresponsive to adequate therapy.

• #22 Pediatric Constipation: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/928185-overview

  Constipation in children has reported prevalence rates between 1% and 30%. It is the principal complaint in 3-5% of all visits to pediatric outpatient clinics and as many as 35% of all visits to pediatric gastroenterologists. […] In the United States, constipation is extremely common among infants and young children. In a 1987 report, Issenman et al found that 16% of parents reported that their 2-year-old children had constipation; 2 decades later, Loening-Baucke reported that the prevalence of constipation was 22.6% among 482 children aged 4-17 years. In a longitudinal study of children aged 9-11 years, Saps et al reported an 18% overall prevalence of constipation. […] In a European study, Yong and Beattie found that 34% of parents in the United Kingdom reported their children aged 4-7 years had at least intermittent difficulties with constipation, and a South American study by de Araujo Sant’Anna and Calcado found that 28% of Brazilian children aged 8-10 years were constipated.

• #23 Constipation in pediatric outpatient gastroenterology clinic – epidemiology and clinical presentation • Postępy Nauk Medycznych 11/2017 • Czytelnia Medyczna BORGIS

  https://www.czytelniamedyczna.pl/6153,constipation-in-pediatric-outpatient-gastroenterology-clinic-epidemiology-and-c.html

  Constipation in pediatric outpatient gastroenterology clinic epidemiology and clinical presentation […] Wedug danych z literatury amerykaskiej problem dotyczy 1,5-7,5% populacji pediatrycznej. Uwaa si, e ok. 25% porad gastroenterologicznych dotyczy zaparcia. […] Zaparcie stolca jest jednym z najczstszych powodw zgaszania si pacjentw na wizyt do poradni gastroenterologicznej. […] Zaparcie jest definiowane jako wyprwania mniej czsto ni 3 razy w tygodniu, z wysikiem i uczuciem niekompletnej defekacji, twardym stolcem i dużą objętością stolca czasami zatyka toaletę. […] Według danych z USA problem dotyczy 1,5-7,5% populacji pediatrycznej. […] U dzieci z zaparciem najczciej zgaszanymi objawami były: ból brzucha (61,6%) oraz defekacje z wysiłkiem (66,7%). […] Zalegające masy kałowe wyczuwalne podczas badania palpacyjnego brzucha obecne były u 55,1%. […] Zaparcie jest jednym z najczstszych zaburzeń gastroenterologicznych w poradniach gastroenterologicznych.

• #24 Asia Pacific Journal of Pediatric and Child Health

  https://www.apjpch.com/?page=article&number=72&article=Does%20Functional%20Constipation%20Affect%20Growth%20Status%20in%20Children?%20-%20A

  Functional constipation is a common pediatric problem in both developed and developing countries. Most common belief being that functional constipation does not affect the growth status of children; however, there are some studies suggesting functional constipation-related growth retardation in children, especially in early childhood. […] Constipation is a common chronic disorder of pediatric age group, affecting 1 to 30% of children worldwide. […] Management of children with constipation costs 3 times more than the children without constipation. […] Current study demonstrated that children with symptoms of functional constipation had much less average weight than children without constipation. Z scores of BMI for age were considerably different in two groups. […] Children with functional constipation may have retarded growth (weight for age and BMI) and poor intake due to anorexia, nausea, and abdominal pain may play contributory role.

• #25 Constipation: A commonly costly complex condition – University of Otago

  https://ourarchive.otago.ac.nz/esploro/outputs/conferencePoster/Constipation-A-commonly-costly-complex-condition/9926479949801891

  Background: The 2015 New Zealand Child and Youth Epidemiology Service reports to NZ district health boards (DHBs) on the health status of children and young people found that constipation was a common reason for acute and arranged hospitalisations of New Zealand children, particularly in the 0–14 age group. Community prevalence may be as high as 30% and the condition results in a significant burden to children, their families and to health services in terms of resource use and funding. This poster includes the epidemiology of hospitalisations for constipation in New Zealand 0–24 year olds from 2000 to 2015 and considers recent evidence for good practice at a health service level. […] Hospitalisation rates of 0–24 year olds for constipation rose markedly from 2007 to 2015. The increase in hospitalisation rates was observed in all age groups and ethnic groups, with consistently highest rates for 0–4 year olds. […] The common problem of constipation is contributing increasingly to use of health service resources in New Zealand. Cost-effective services can reduce this impact and contribute to better outcomes for children and families.

• #26

  https://link.springer.com/article/10.1007/s40272-023-00563-0

  A large proportion of children with FC respond well to treatment with acceptable side effects and will recover within a year. […] The prognosis and prognostic factors of FC in children were investigated in a systematic review, including 14 heterogeneous prospective follow-up studies with a total of 1752 children. […] This systematic review reported that half of the children treated for FC were recovered and taken off laxatives after 6-12 months of follow-up.

• #27 :: PGHN :: Pediatric Gastroenterology, Hepatology & Nutrition

  https://pghn.org/DOIx.php?id=10.5223/pghn.2021.24.1.45

  Constipation and fecal incontinence are common pediatric disorders. It is often assumed that children outgrow these defecation problems. However, a number of studies have shown that a significant proportion of children with constipation (20-52%) still have symptoms after several years of treatment. Furthermore, van Ginkel and colleagues reported that constipation still occurred in 30% of patients after puberty. Moreover, even after seemingly successful treatment, 17% of the girls and 41% of the boys had a relapse of symptoms. According to Bongers and colleagues, the prognostic factors for poor long-term outcomes in children who experienced constipation were a long delay between the onset of symptoms and first visit to the doctor and lower defecation frequency. Even though symptoms persist in many patients despite years of treatment, the symptoms are expected to improve after the transition from childhood to adulthood. Unfortunately, it is difficult to study the development of defecation disorders across this transition period, because the criteria for diagnosing constipation and fecal incontinence in children and adults differ. As a consequence, most longitudinal studies only use certain associated symptoms to study the development of defecation disorders instead of using the complete set of diagnostic criteria. To study the actual difference in the prevalence of defecation disorders between children and young adults, and to follow patients’ treatment progress during their transition from childhood to adulthood, the same diagnostic criteria must be used for both children and young adults. It is important to gain more insight into the developmental course of symptoms of constipation and fecal incontinence from childhood to adulthood. If the children have not outgrown these defecation disorders, then one should intervene as soon as possible, especially because chronic constipation and fecal incontinence are associated with reduced quality of life, psychological maladjustment, and high healthcare costs.

• #28 :: PGHN :: Pediatric Gastroenterology, Hepatology & Nutrition

  https://pghn.org/DOIx.php?id=10.5223/pghn.2021.24.1.45

  In our pediatric study population, 33 children (15.6%) had constipation, of whom a quarter also had co-existing fecal incontinence; meanwhile, 34 young adults (22.8%) had constipation, of whom 15% also had co-existing fecal incontinence. No significant difference was observed in the prevalence rate between children and young adults. Fecal incontinence occurred as often in children as in young adults (15 [7.1%] and 11 [7.4%], respectively). […] In conclusion, in contrast to the general belief that children outgrow defecation disorders, the prevalence and occurrence rates of associated symptoms seem to be comparable between children and young adults. Since many children do not outgrow their disorders, constipation and fecal incontinence should be treated as early as possible. Currently, only a small proportion of children and young adults with defecation disorders receive adequate (symptomatic) treatment.

• #29 Functional constipation in children: challenges and solutions | PHMT

  https://www.dovepress.com/functional-constipation-in-children-challenges-and-solutions-peer-reviewed-fulltext-article-PHMT

  FC is a common childhood problem with varied prevalence between geographic regions. […] A recent systematic review found that the median prevalence of constipation in children was 12%. […] Many factors contribute to the large variation in the reported prevalence of constipation in children such as differences in definition, differences in age groups, and methodology. […] Although effective and safe treatment options have been reported in children with FC, a lot of challenges persist. Epidemiological data from some parts of the world are still missing. […] The new Rome IV criteria have adjusted some criteria, which should make it easier for the diagnosis of FC in younger children, but new studies are needed to evaluate its usefulness in everyday practice. […] The majority of the studies evaluating management of FC are done in second or tertiary centers where children suffering from long-lasting and therapy-resistant chronic constipation, but the majority of children who experience constipation and whose parents seek medical care present themselves at primary health care.

• #30 Functional constipation in infancy and early childhood: epidemiology, risk factors, and healthcare consultation | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-019-1652-y

  A total of 89 infants and toddlers (8%) fulfilled the Rome III criteria for FC. […] Children living in urban areas of the district showed a significant association with FC compared to children in rural areas (9.6% vs 5.6%, p =0.013). [OR and 95% CI were 0.592 (CI; 0.3960.95)]. […] The majority of children with FC were treated with dietary manipulations and non-pharmacological interventions, while almost 40 % of the children received laxatives. […] FC is a common clinical problem in infants and young children in Sri Lanka. Living in urban areas and being underweight for the age are significantly and independently associated with FC. […] One quarter of children received treatment by a medical doctor for their symptoms and a large proportion of infants and young children received ineffective therapeutic interventions according to currently accepted guidelines.

• #31

  https://link.springer.com/article/10.1007/s40272-023-00563-0

  Functional constipation is a common problem in childhood worldwide and has a great impact on social, physical, and emotional functioning of affected children and their caregivers. […] Functional constipation (FC) is a common problem in childhood, with a worldwide pooled prevalence of 9.5%. […] According to the international guideline from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN), the first step in the treatment of FC consists of education, demystification, and lifestyle advice. […] Despite medical interventions, a large proportion of patients remain symptomatic. In secondary and tertiary care settings, 40% of treated children have been reported to remain symptomatic after 6-12 months.

• #32 Chronic constipation in infants and children | SMJ

  http://www.smj.org.sg/article/chronic-constipation-infants-and-children

  Beneath the surface, chronic constipation in children is actually a complex condition, contrary to what one might think. Biological, psychological and social factors interact in the ever-changing context of a developing child. […] Most children with chronic constipation are caught in a vicious cycle. The cycle can start at any point and deepen its roots with each revolution. […] The two pillars in the management of chronic constipation are behavioural modification and medications. […] Common pharmacology management includes osmotic laxatives or stimulant laxatives for older children, while topical lignocaine can be considered for pain relief.

• #33 Epidemiology of Childhood Constipation: A Systematic Review. | EBSCOhost

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  OBJECTIVE: A systematic review of the published literature was performed to assess the prevalence, incidence, natural history, and comorbid conditions of functional constipation in children. […] RESULTS: Eighteen studies met our inclusion criteria. The prevalence of childhood constipation in the general population ranged from 0.7% to 29.6% (median 8.9; inter quartile range 5.3-17.4). […] CONCLUSION: Childhood constipation is a common problem worldwide. Most studies report similar prevalence rates for boys and girls. Large epidemiologic studies with the use of generally accepted diagnostic criteria are needed to define the precise prevalence of constipation.

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