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Medline ® Abstracts for References 15,18,127,130

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
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
127
TI
Chronic constipation in childhood: a longitudinal study of 186 patients.
AU
Abrahamian FP, Lloyd-Still JD
SO
J Pediatr Gastroenterol Nutr. 1984;3(3):460.
 
One hundred eighty-six patients with chronic constipation and soiling were seen between 1975 and 1982. On follow-up, 47% had resolution of symptoms, with another 36% having their soiling controlled with either continuous or intermittent laxatives. Thirteen clinical features were analyzed in relation to outcome. The only predictor of poor outcome was the presence of soiling (p = 0.003), while the presence of abdominal pain correlated well with cure (p = 0.007). Fifty-five percent of patients had a positive family history for constipation. Significant psychological problems were present in 20% of patients; however, these did not appear to affect the outcome. Constipation was uncommon over the age of 12 years, and there was no evidence of the development of laxative dependence. These findings suggest that chronic idiopathic constipation of childhood may be a constitutional condition which tends to resolve with age.
AD
PMID
130
TI
Factors determining outcome in children with chronic constipation and faecal soiling.
AU
Loening-Baucke V
SO
Gut. 1989;30(7):999.
 
To evaluate factors which might contribute to treatment failure in children with chronic constipation and soiling, we evaluated the history, physical findings, defecation dynamics, and anorectal function in 97 patients. We treated them with milk of magnesia, high fibre diet, and bowel training techniques and evaluated outcome at one year when 43% had recovered. Recovery rates were similar for boys and girls. Fifty seven per cent of the patients had not recovered. This group at the outset had more frequent soiling episodes, more severe constipation, were less likely to defecate water filled rectal balloons and to relax the external sphincter during defecation. In general girls had more severe constipation, abdominal pain, and a previous urinary tract infection than boys. Girls were more compliant during treatment and had less frequent soiling episodes at one year. Stepwise logistic regression showed that severe constipation, abnormal contraction of the external sphincter and pelvic floor during attempted defecation, and inability to defecate the 100 ml balloon in less than or equal to 1 min was significantly related to treatment failure. Defecation of smaller balloons, volumes for threshold of rectal sensation, critical volume and rectal contraction, and compliance with treatment could not predict treatment failure.
AD
Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City 52242.
PMID