Medline ® Abstracts for References 17,85,86
of 'Chronic functional constipation and fecal incontinence in infants and children: Treatment'
Childhood constipation: evaluation and treatment.
Youssef NN, Di Lorenzo C
J Clin Gastroenterol. 2001;33(3):199.
Constipation is common in children. It is estimated that between 5% and 10% of pediatric patients have constipation and/or encopresis. Constipation is the second most referred condition in pediatric gastroenterology practices, accounting for up to 25% of all visits. In this article, a practical approach is laid out for those not familiar with constipation in children. Emphasis is placed on the evaluation and management options that are available to the treating practitioner. The diagnosis of constipation requires careful history taking and interpretation. Diagnostic tests are not often needed and are reserved for those who are severely affected. The daily bowel habits of children are extremely susceptible to any changes in routine environment. Constipation and subsequent fecal retention behavior often begins soon after a child has experienced a painful evacuation. Childhood constipation can be very difficult to treat. It often requires prolonged support by physicians and parents, explanation, medical treatment, and, most important, the child's cooperation.
Department of Pediatrics, Division of Gastroenterology, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
Belamarich PF. Constipation. In: Primary Pediatric Care, 4th, Hoekelman RA (Ed), Mosby, St. Louis 2001. p.1066.
no abstract available
New concepts in the management of encopresis.
Nolan T, Oberklaid F
Pediatr Rev. 1993;14(11):447.
Persistent fecal incontinence without anatomic abnormality, otherwise known as soiling or encopresis, frequently brings ridicule and shame to the affected child. The disability that it imposes is accentuated by the parental anger, guilt, and helplessness it engenders; by the peer hostility and rejection it promotes; and by the disgust with which it may be greeted by teachers. Home-based pediatric therapy is safe, generally very effective, and rewarding to patient, family, and physician. However, it requires a comprehensive understanding of both the underlying pathophysiology and the integrated therapeutic program of counseling, pharmacotherapy, and behavior modification.
Melbourne University Department of Paediatrics, Royal Children's Hospital, Australia.