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. 1996 Jul;75(1):36–41. doi: 10.1136/adc.75.1.36

Diagnostic dilemmas and results of treatment for chronic constipation.

C W Keuzenkamp-Jansen 1, C J Fijnvandraat 1, C M Kneepkens 1, A C Douwes 1
PMCID: PMC1511680  PMID: 8813868

Abstract

Chronic functional constipation (CFC) may be difficult to recognise and information regarding its long term prognosis is scarce. The records of 244 children with CFC, aged 0-18 years, were analysed for symptoms at presentation and results of treatment, and long term outcome was evaluated by means of a telephone interview in 137 patients discharged for more than one year. The patients presented with a great variety of symptoms, only 22% having infrequent defecation of increased consistency, another 22% having an obviously normal defecation pattern. The mean duration of treatment was 13 months. At the time of discharge, 69% of the patients still used laxatives. At a median of four years after discharge, 66% of the children were free of symptoms and without medication, 39% having experienced a recurrence. It is concluded that CFC may be difficult to recognise and can be alleviated by an intensive laxative regimen. Recurrence of symptoms is common, but the long term prognosis is good in most patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abrahamian F. P., Lloyd-Still J. D. Chronic constipation in childhood: a longitudinal study of 186 patients. J Pediatr Gastroenterol Nutr. 1984 Jun;3(3):460–467. doi: 10.1097/00005176-198406000-00027. [DOI] [PubMed] [Google Scholar]
  2. Barr R. G., Levine M. D., Wilkinson R. H., Mulvihill D. Chronic and occult stool retention: a clinical tool for its evaluation in school-aged children. Clin Pediatr (Phila) 1979 Nov;18(11):674, 676, 677-9, passim. doi: 10.1177/000992287901801103. [DOI] [PubMed] [Google Scholar]
  3. Benninga M. A., Büller H. A., Heymans H. S., Tytgat G. N., Taminiau J. A. Is encopresis always the result of constipation? Arch Dis Child. 1994 Sep;71(3):186–193. doi: 10.1136/adc.71.3.186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Benninga M. A., Büller H. A., Staalman C. R., Gubler F. M., Bossuyt P. M., van der Plas R. N., Taminiau J. A. Defaecation disorders in children, colonic transit time versus the Barr-score. Eur J Pediatr. 1995 Apr;154(4):277–284. doi: 10.1007/BF01957362. [DOI] [PubMed] [Google Scholar]
  5. Benninga M. A., Büller H. A., Taminiau J. A. Biofeedback training in chronic constipation. Arch Dis Child. 1993 Jan;68(1):126–129. doi: 10.1136/adc.68.1.126. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Clayden G. S., Lawson J. O. Investigation and management of long-standing chronic constipation in childhood. Arch Dis Child. 1976 Dec;51(12):918–923. doi: 10.1136/adc.51.12.918. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cucchiara S., Coremans G., Staiano A., Corazziari E., Romaniello G., Di Lorenzo C., Tamburrini O., Auricchio S. Gastrointestinal transit time and anorectal manometry in children with fecal soiling. J Pediatr Gastroenterol Nutr. 1984 Sep;3(4):545–550. doi: 10.1097/00005176-198409000-00012. [DOI] [PubMed] [Google Scholar]
  8. DAVIDSON M., KUGLER M. M., BAUER C. H. Diagnosis and management in children with severe and protracted constipation and obstipation. J Pediatr. 1963 Feb;62:261–275. doi: 10.1016/s0022-3476(63)80404-7. [DOI] [PubMed] [Google Scholar]
  9. Dimson S. B. Transit time related to clinical findings in children with recurrent abdominal pain. Pediatrics. 1971 Apr;47(4):666–674. [PubMed] [Google Scholar]
  10. Hatch T. F. Encopresis and constipation in children. Pediatr Clin North Am. 1988 Apr;35(2):257–280. doi: 10.1016/s0031-3955(16)36431-8. [DOI] [PubMed] [Google Scholar]
  11. Karlbom U., Påhlman L., Nilsson S., Graf W. Relationships between defecographic findings, rectal emptying, and colonic transit time in constipated patients. Gut. 1995 Jun;36(6):907–912. doi: 10.1136/gut.36.6.907. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Levine M. D., Bakow H. Children with encopresis: a study of treatment outcome. Pediatrics. 1976 Dec;58(6):845–852. [PubMed] [Google Scholar]
  13. Levine M. D. Children with encopresis: A descriptive analysis. Pediatrics. 1975 Sep;56(3):412–416. [PubMed] [Google Scholar]
  14. Loening-Baucke V. A., Cruikshank B. M. Abnormal defecation dynamics in chronically constipated children with encopresis. J Pediatr. 1986 Apr;108(4):562–566. doi: 10.1016/s0022-3476(86)80834-4. [DOI] [PubMed] [Google Scholar]
  15. Loening-Baucke V. A., Younoszai M. K. Abnormal and sphincter response in chronically constipated children. J Pediatr. 1982 Feb;100(2):213–218. doi: 10.1016/s0022-3476(82)80637-9. [DOI] [PubMed] [Google Scholar]
  16. Loening-Baucke V. Constipation in early childhood: patient characteristics, treatment, and longterm follow up. Gut. 1993 Oct;34(10):1400–1404. doi: 10.1136/gut.34.10.1400. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Loening-Baucke V. Factors determining outcome in children with chronic constipation and faecal soiling. Gut. 1989 Jul;30(7):999–1006. doi: 10.1136/gut.30.7.999. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Loening-Baucke V. Modulation of abnormal defecation dynamics by biofeedback treatment in chronically constipated children with encopresis. J Pediatr. 1990 Feb;116(2):214–222. doi: 10.1016/s0022-3476(05)82877-x. [DOI] [PubMed] [Google Scholar]
  19. Lowery S. P., Srour J. W., Whitehead W. E., Schuster M. M. Habit training as treatment of encopresis secondary to chronic constipation. J Pediatr Gastroenterol Nutr. 1985 Jun;4(3):397–401. doi: 10.1097/00005176-198506000-00013. [DOI] [PubMed] [Google Scholar]
  20. Metcalf A. M., Phillips S. F., Zinsmeister A. R., MacCarty R. L., Beart R. W., Wolff B. G. Simplified assessment of segmental colonic transit. Gastroenterology. 1987 Jan;92(1):40–47. doi: 10.1016/0016-5085(87)90837-7. [DOI] [PubMed] [Google Scholar]
  21. Molnar D., Taitz L. S., Urwin O. M., Wales J. K. Anorectal manometry results in defecation disorders. Arch Dis Child. 1983 Apr;58(4):257–261. doi: 10.1136/adc.58.4.257. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Nolan T., Debelle G., Oberklaid F., Coffey C. Randomised trial of laxatives in treatment of childhood encopresis. Lancet. 1991 Aug 31;338(8766):523–527. doi: 10.1016/0140-6736(91)91097-e. [DOI] [PubMed] [Google Scholar]
  23. O'Regan S., Yazbeck S., Hamberger B., Schick E. Constipation a commonly unrecognized cause of enuresis. Am J Dis Child. 1986 Mar;140(3):260–261. doi: 10.1001/archpedi.1986.02140170086039. [DOI] [PubMed] [Google Scholar]
  24. Olness K., McParland F. A., Piper J. Biofeedback: a new modality in the management of children with fecal soiling. J Pediatr. 1980 Mar;96(3 Pt 1):505–509. doi: 10.1016/s0022-3476(80)80711-6. [DOI] [PubMed] [Google Scholar]
  25. Rockney R. M., McQuade W. H., Days A. L. The plain abdominal roentgenogram in the management of encopresis. Arch Pediatr Adolesc Med. 1995 Jun;149(6):623–627. doi: 10.1001/archpedi.1995.02170190033006. [DOI] [PubMed] [Google Scholar]
  26. Stone R. T., Barbero G. J. Recurrent abdominal pain in childhood. Pediatrics. 1970 May;45(5):732–738. [PubMed] [Google Scholar]
  27. Taitz L. S., Wales J. K., Urwin O. M., Molnar D. Factors associated with outcome in management of defecation disorders. Arch Dis Child. 1986 May;61(5):472–477. doi: 10.1136/adc.61.5.472. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Whitehead W. E., Parker L., Bosmajian L., Morrill-Corbin E. D., Middaugh S., Garwood M., Cataldo M. F., Freeman J. Treatment of fecal incontinence in children with spina bifida: comparison of biofeedback and behavior modification. Arch Phys Med Rehabil. 1986 Apr;67(4):218–224. [PubMed] [Google Scholar]

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