title: Constipation in children.
abstract: BACKGROUND
  Prevalence of childhood constipation has been estimated at 0.7% to 29.6% in the general population worldwide; most children have no obvious aetiological factors. One third of children with chronic constipation continue to have problems beyond puberty. Half of children with chronic faecal impaction and faecal incontinence have experienced an episode of painful defecation, and many children with chronic constipation exhibit withholding behaviour.
  
  
  METHODS
  We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for children with chronic constipation? What are the effects of treatments for clearing the bowel in children with faecal impaction? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
  
  
  RESULTS
  We found 14 systematic reviews and RCTs that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
  
  
  CONCLUSIONS
  In this systematic review, we present information relating to the effectiveness and safety of the following interventions: anal dilatation, behavioural treatments (biofeedback, diaries, or toilet training), bulk-forming laxatives, enemas, faecal softeners, fibre, macrogols, oral fluids, osmotic laxatives, prebiotics, probiotics, stimulant laxatives, and surgical disimpaction.
authors: Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
authors: Merit M
authors: MM
authors: Tabbers
authors: Nicole
authors: N
authors: Boluyt
authors: Marjolein Y
authors: MY
authors: Berger
authors: Marc A
authors: MA
authors: Benninga
mesh_terms: D000284:Administration, Oral; D002648:Child; D003248:Constipation / Q000188:drug therapy; D005242:Fecal Incontinence / Q000188:drug therapy; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012741:Sexual Maturation
chemical_list: D054368:Laxatives; D011092:Polyethylene Glycols