Constipation in otherwise healthy infants and children is a common problem despite confusion about how to precisely define constipation and constipation-related disorders. Constipation may, rarely, be a sign or symptom of a more serious disease or a diagnosis defined only by its symptoms and without any structural or biochemical findings. In the latter case it is classified as a functional gastrointestinal disorder (FGID). FGIDs are defined as disorders that cannot be explained by structural or biochemical findings. The Rome Foundation has standardized diagnostic criteria for all FGIDs. The Rome criteria are based on the available research as well as the clinical experience of the Foundation’s assembled experts. The most recent report, Rome IV, described clinical criteria and diagnostic tools and encouraged more rigorous research in the area of FGIDs. The true incidence and prevalence of constipation is difficult to know because it may be treated at home using home remedies or diagnosed at a visit to a primary care provider or to a subspecialist pediatric gastroenterologist. The most recent attempts to define the prevalence of all pediatric FGIDs have been made using the Rome IV criteria. The defined FGID entities that may be associated with the complaint of constipation are infant dyschezia, functional constipation, and nonretentive fecal incontinence. The term encopresis, omitted from Rome IV, is defined by the American Psychiatric Association (APA) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The 3 Rome-defined (constipation-related) entities and the APA entity of encopresis are the focus of this review.
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August 2020
Articles|
August 01 2020
Constipation
Neal S. LeLeiko, MD, PhD;
Neal S. LeLeiko, MD, PhD
*Department of Pediatrics,
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Sarah Mayer-Brown, PhD;
Sarah Mayer-Brown, PhD
†Department of Psychiatry and Human Behavior, Hasbro Children’s Hospital/Rhode Island Hospital, Warren Alpert School of Medicine at Brown University, Providence, RI
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Carolina Cerezo, MD;
Carolina Cerezo, MD
*Department of Pediatrics,
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Wendy Plante, PhD
Wendy Plante, PhD
†Department of Psychiatry and Human Behavior, Hasbro Children’s Hospital/Rhode Island Hospital, Warren Alpert School of Medicine at Brown University, Providence, RI
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AUTHOR DISCLOSURE
Drs LeLeiko, Mayer-Brown, Cerezo, and Plante have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Pediatr Rev (2020) 41 (8): 379–392.
Citation
Neal S. LeLeiko, Sarah Mayer-Brown, Carolina Cerezo, Wendy Plante; Constipation. Pediatr Rev August 2020; 41 (8): 379–392. https://doi.org/10.1542/pir.2018-0334
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