Constipation 2013

Key words: Childhood, Functional constipation, Case-management, Oral laxatives, Polyethylene glycol, Review

Constipation in children can be a long-lasting paediatric functional gastrointestinal disorder with a high prevalence in the western world. A complete medical history and physical examination, in combination with a bowel movements description, can lead to diagnose constipation in the majority of cases. Typical diagnostic findings of functional constipation can be pointed out instead of warning symptoms for organic constipation; diagnostic help can be eventually found in few and simple blood exams. Chronic functional constipation can bring to a decreased quality of life and to higher prevalence of behavioural problems. The current standard treatment consists of education, initial faecal disimpaction, toilet training, maintenance therapy and long-term follow-up. In the past decade, well-designed treatment trials in the paediatric population have emerged and long-term outcome studies have been completed, more recently several review and metaanalysis have brought lights on this issue. This article summarizes the current knowledge of functional childhood constipation applied to a single clinical case, with particular emphasis on the latest available evidence based data.