[Functional childhood gastrointestinal disorders. III. Constipation and solitary encopresis; diagnostic work-up and therapy].
A detailed medical history in combination with a thorough physical examination, including rectal examination, form the cornerstone in the diagnostic work-up for children with functional defecation disorders. Additional investigations are often not informative and have only minor diagnostic or therapeutic implications. Medical therapy in children with functional constipation and solitary encopresis is primarily based on clinical experience. In both patient groups, the role of education, the use of diary cards and toilet training is important. In some patients behaviour interventions are important. Oral laxatives are the basis of treatment of children with functional constipation, whereas they are contra-indicated in children with solitary encopresis. In both groups, biofeedback training appears to be of little additional benefit. Long-term follow-up of children with functional defecation disorders shows that complaints continue far beyond puberty in many children.
van Ginkel
R
R
Afd. Kindergastro-enterologie en voeding, Academisch Medisch Centrum/Emma Kinderziekenhuis, Meibergdreef 9, 1105 AZ Amsterdam.
Büller
H A
HA
Heymans
H S
HS
Taminiau
J A
JA
Boeckxstaens
G E
GE
Benninga
M A
MA
D002400:Cathartics / Q000627:therapeutic use*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003248:Constipation / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D000075202:Contraindications; D003672:Defecation / Q000187:drug effects / Q000502:physiology; D003937:Diagnosis, Differential; D004688:Encopresis / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D005772:Gastrointestinal Transit / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007420:Intestine, Large / Q000503:physiopathology; D008487:Medical History Taking; D010808:Physical Examination; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy
D002400:Cathartics