Advances in the management of pediatric constipation.
Constipation in children is a common concern. There is no single treatment; many children do not respond and continue to have chronic problems. This lack of response is multifactorial, but it is most likely related to the fact that the exact pathophysiology of constipation in children is not known. Diagnostic criteria (Rome II classification) and algorithms proposed by the North American Society for Pediatric Gastroenterology and Nutrition (NASPGN) for evaluation and treatment of children with constipation were recently published and are summarized here. The effectiveness of new treatments such as dietary interventions, prokinetic agents, biofeedback, and polyethylene-glycol electrolyte (PEG) solutions is discussed in this review.
Nurko
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Combined Program in Pediatric Gastroenterology and Nutrition, Children's Hospital, Boston, MA 02115, USA. Nurko@a1.Tch.harvard.edu
D001676:Biofeedback, Psychology; D002648:Child; D002675:Child, Preschool; D020117:Cisapride / Q000627:therapeutic use; D003248:Constipation / Q000145:classification / Q000503:physiopathology / Q000628:therapy*; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D009747:Nutritional Physiological Phenomena; D011092:Polyethylene Glycols / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D013501:Surface-Active Agents / Q000627:therapeutic use
D005765:Gastrointestinal Agents; D013501:Surface-Active Agents; D011092:Polyethylene Glycols; D020117:Cisapride