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Medline ® Abstracts for References 15,16,18,128

of 'Chronic functional constipation and fecal incontinence in infants and children: Treatment'

15
TI
Controversies in the management of chronic constipation.
AU
Loening-Baucke V
SO
J Pediatr Gastroenterol Nutr. 2001;32 Suppl 1:S38.
 
AD
Department of Pediatrics, University of Iowa, Iowa City, USA.
PMID
16
TI
Encopresis.
AU
Loening-Baucke V
SO
Curr Opin Pediatr. 2002;14(5):570.
 
A careful history and physical examination will help to differentiate between encopresis with or without constipation and fecal incontinence caused by anatomic or organic disease. Most children with encopresis with or without functional constipation require no or minimal laboratory workup. Successful treatment of encopresis requires a combination of parent and child education, behavioral intervention, medical therapy, and long-term compliance with the treatment regimen. The conventional treatment approach consists of behavior modification and laxative for children with encopresis with constipation and behavior modification alone for the few children with encopresis without constipation. Almost every patient will experience dramatic improvement in encopresis. Recovery rates are 30% to 50% after 1 year and 48% to 75% after 5 years.
AD
Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Iowa, Iowa City, 52242-1083, USA. vera-loening-baucke@uiowa.edu
PMID
18
TI
Long-term follow-up of children with chronic idiopathic constipation.
AU
Staiano A, Andreotti MR, Greco L, Basile P, Auricchio S
SO
Dig Dis Sci. 1994;39(3):561.
 
To determine the outcome of chronic idiopathic constipation, we followed 62 children with chronic idiopathic constipation (mean age: 5.2 +/- 2.8 years) for a period of five years. Each child received the same initial treatment over a 12-week period and was then followed every three months. After five years from diagnosis, chronic idiopathic constipation persisted in 52% of the children; 47% who remained symptomatic were>10 years old at the time of the five-year evaluation. Of the 27 who were constipated in the first year of life, 63% remained constipated after five years. Children who recovered within the five-year interval were significantly different from those that remained symptomatic in age of onset of constipation (P<0.05) and family history of constipation (P<0.05). After five years, both severity of abdominal pain and degree of soiling significantly decreased in both the recovered and unrecovered groups (P<0.05). This study suggests that chronic idiopathic constipation persists for>or = 5 years in at least half of children. Early age of onset and family history of constipation are predictive of persistence. Abdominal pain and soiling improve in long-term follow-up irrespective of constipation outcome.
AD
Department of Pediatrics, II School of Medicine, University of Naples, Italy.
PMID
128
TI
Long-term follow-up of medically treated childhood constipation.
AU
Sutphen JL, Borowitz SM, Hutchison RL, Cox DJ
SO
Clin Pediatr (Phila). 1995;34(11):576.
 
We describe the long-term (mean 6.8 years) follow-up of 43 children treated medically for chronic constipation and encopresis. Overall outcome was quite good. Thirty children (70%) were entirely asymptomatic at follow-up. Intermittent mild constipation persisted in 13 patients; only two required persistent but infrequent laxative therapy. Encopresis persisted in three of 17 children who initially reported this symptom, and was associated with significant behavioral problems.
AD
Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
PMID