title: Constipation in children: fibre and probiotics.
abstract: BACKGROUND
  Prevalence of childhood constipation has been estimated at 1% to 30% 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 the 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 fibre for children with chronic constipation? What are the effects of probiotics for children with chronic constipation? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2014 (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 12 studies 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: fibre and probiotics.
authors.affiliation: Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Merit M
authors.initials: MM
authors.lastname: Tabbers
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
mesh_terms: D002648:Child; D003248:Constipation / Q000178:diet therapy / Q000628:therapy*; D004043:Dietary Fiber; D006801:Humans; D019936:Probiotics; D016896:Treatment Outcome
chemical_list: D004043:Dietary Fiber