One important etiological factor, especially in young children, is withholding behavior, frequently occurring after a negative experience-e.g., a hard, painful, and/or frightening bowel movement. The pathophysiology of FC is still incompletely understood but is likely to be multifactorial. In the remainder of cases, constipation has an organic cause, such as a metabolic or endocrine disorder, anorectal anomalies, neuromuscular diseases, or Hirschsprung’s disease. In approximately 95 % of children with constipation, no organic cause can be identified. In the spring of 2016, the newly revised Rome IV criteria are expected to be published.įC not responding to optimal conventional treatment for at least 3 months is defined as intractable constipation. The Rome III criteria for FC in children differentiate between children up to 4 years of age and children aged ≥4 years. To define FC and other functional defecation disorders in children, the Rome III criteria were defined by a group of pediatric gastroenterology experts in 2006. This review focuses on the current approach to management of FC in the pediatric population and provides practical guidance, including a summary of drug treatment options. Furthermore, the same study revealed that the mean total unadjusted annual expenditure for children with constipation was three times higher than that for children without constipation (US$3430/year versus US$1099/year). In the USA, the total additional costs for childhood constipation have been estimated to be US$3.9 billion per year. Estimations of the economic burden caused by childhood FC vary between studies. Furthermore, healthcare costs for children with constipation are higher than those for control subjects, mostly because of ambulatory care costs and, to a lesser degree, costs related to hospitalizations and emergency room visits. ![]() It is estimated that constipation in children accounts for 3 % of visits to a general pediatrician and up to 25 % of visits to a pediatric gastroenterologist in the USA. These symptoms can have a significant impact on a child’s well-being and health-related quality of life. FC is characterized by infrequent bowel movements, hard and/or large stools, painful defecation, and fecal incontinence, and is often accompanied by abdominal pain. Functional constipation (FC) is a common pediatric healthcare problem worldwide, with reported prevalences ranging between 0.7 and 29.6 % and a mean female-to-male ratio of 2.1:1.
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