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BROWSE EVIDENCE REPOSITORY

 

Bottom Line Recommendations English (1) French All (1)

Bottom Line: Flowchart of evaluation and management of functional constipation in children

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Koppen IJ, Lammers LA, Benninga MA, Tabbers MM

Flowchart of evaluation and management of functional constipation in children.

Bottom Line: Flowchart of evaluation and management of functional constipation in children

Visit

Koppen IJ, Lammers LA, Benninga MA, Tabbers MM

Flowchart of evaluation and management of functional constipation in children.

Clinical guidelines English (10) French All (10)

Guidelines: Constipation in Children and Young People: Diagnosis and Management

Visit

National Institute for Health and Care Excellence

This guideline covers diagnosing and managing constipation in children and young people up to 18. It provides strategies to support the early identification and timely, effective treatment of constipation which will help improve outcomes for patients. It does not cover constipation caused by a specific condition.

Guidelines: Constipation

Visit

Royal Children's Hospital Melbourne

These clinical practice guidelines cover the description, etiology, diagnosis and management of constipation in children.

Guidelines: Childhood Functional Gastrointestinal Disorders: Neonate/Toddler

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Benninga MA, Faure C, Hyman PE, St James Roberts I, Schechter NL, Nurko S

This article provides a description, assessment, and analysis of each functional gastrointestinal intestinal disorder that affects the neonate/toddler age group.

Guidelines: Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV

Visit

Drossman DA

This summary article about the Rome IV diagnostic criteria describes the the field of functional gastrointestinal disorders, distinguishes them from motility and structural disorders, discusses the changes from the Rome III criteria, reviews the Rome committee process, provides a biopsychological pathophysiological conceptualization of functional gastrointestinal disorders, and offers an approach to patient care.

Guidelines: Functional Disorders: Children and Adolescents

Visit

Hyams JS, Di Lorenzo C, Saps M, Shulman RJ, Staiano A, van Tilburg M

The Rome criteria provide symptom-based guidelines by which child and adolescent functional gastrointestinal disorders (FGID) can be diagnosed.

Guidelines: Constipation

Visit

Kids Health WA

These emergency department guidelines cover the background, assessment and management of constipation in children.

Guidelines: Management of Functional Constipation

Visit

SickKids

This pathway is for use with children aged 1-18 years old with no underlying disease or cormorbidity who have been diagnosed with functional constipation.

Guidelines: Evaluation and treatment of constipation in children and adolescents

Visit

Nurko S, Zimmerman LA

These clinical practice guidelines cover the definition, etiology and pathophysiology, diagnosis, differential diagnosis and treatment of constipation in infants younger than six months, and also in children six months and older.

Guidelines: Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN

Visit

Tabbers MM, DiLorenzo C, Berger MY, Faure C, Langendam MW, Nurko S, Staiano A...

This evidence-based guideline provides recommendations for the evaluation and treatment of children withfunctionalconstipation to standardize and improve their quality of care. In addition, 2 algorithms were developed, one for the infants under 6 months of age and the other for older infants and children.

Guidelines: Managing functional constipation in children

Visit

Rowan-Legg A; Canadian Paediatric Society, Community Paediatrics Committee

These guidelines are published in English and French, and cover the description, etiology, diagnosis and management, including long-term treatments and behavioural modifications and education, for functional constipation in children.

Guidelines: Constipation in Children and Young People: Diagnosis and Management

Visit

National Institute for Health and Care Excellence

This guideline covers diagnosing and managing constipation in children and young people up to 18. It provides strategies to support the early identification and timely, effective treatment of constipation which will help improve outcomes for patients. It does not cover constipation caused by a specific condition.

Guidelines: Constipation

Visit

Royal Children's Hospital Melbourne

These clinical practice guidelines cover the description, etiology, diagnosis and management of constipation in children.

Guidelines: Childhood Functional Gastrointestinal Disorders: Neonate/Toddler

Visit

Benninga MA, Faure C, Hyman PE, St James Roberts I, Schechter NL, Nurko S

This article provides a description, assessment, and analysis of each functional gastrointestinal intestinal disorder that affects the neonate/toddler age group.

Guidelines: Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV

Visit

Drossman DA

This summary article about the Rome IV diagnostic criteria describes the the field of functional gastrointestinal disorders, distinguishes them from motility and structural disorders, discusses the changes from the Rome III criteria, reviews the Rome committee process, provides a biopsychological pathophysiological conceptualization of functional gastrointestinal disorders, and offers an approach to patient care.

Guidelines: Functional Disorders: Children and Adolescents

Visit

Hyams JS, Di Lorenzo C, Saps M, Shulman RJ, Staiano A, van Tilburg M

The Rome criteria provide symptom-based guidelines by which child and adolescent functional gastrointestinal disorders (FGID) can be diagnosed.

Guidelines: Constipation

Visit

Kids Health WA

These emergency department guidelines cover the background, assessment and management of constipation in children.

Guidelines: Management of Functional Constipation

Visit

SickKids

This pathway is for use with children aged 1-18 years old with no underlying disease or cormorbidity who have been diagnosed with functional constipation.

Guidelines: Evaluation and treatment of constipation in children and adolescents

Visit

Nurko S, Zimmerman LA

These clinical practice guidelines cover the definition, etiology and pathophysiology, diagnosis, differential diagnosis and treatment of constipation in infants younger than six months, and also in children six months and older.

Guidelines: Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN

Visit

Tabbers MM, DiLorenzo C, Berger MY, Faure C, Langendam MW, Nurko S, Staiano A...

This evidence-based guideline provides recommendations for the evaluation and treatment of children withfunctionalconstipation to standardize and improve their quality of care. In addition, 2 algorithms were developed, one for the infants under 6 months of age and the other for older infants and children.

Guidelines: Managing functional constipation in children

Visit

Rowan-Legg A; Canadian Paediatric Society, Community Paediatrics Committee

These guidelines are published in English and French, and cover the description, etiology, diagnosis and management, including long-term treatments and behavioural modifications and education, for functional constipation in children.

Overviews of systematic reviews English (2) French All (2)

Cochrane Summary: Laxatives for the management of childhood constipation

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Gordon M, MacDonald JK, Parker CE, Akobeng AK, Thomas AG

This summary addresses the questions: What are the effectiveness and side effects of osmotic and stimulant laxatives used for the treatment of functional childhood constipation?

Guideline Summary: Idiopathic constipation in children clinical practice guidelines

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Paul SP, Broad SR, Spray C

This is a review of current guidelines for diagnosing and managing idiopathic constipation in children.

Cochrane Summary: Laxatives for the management of childhood constipation

Visit

Gordon M, MacDonald JK, Parker CE, Akobeng AK, Thomas AG

This summary addresses the questions: What are the effectiveness and side effects of osmotic and stimulant laxatives used for the treatment of functional childhood constipation?

Guideline Summary: Idiopathic constipation in children clinical practice guidelines

Visit

Paul SP, Broad SR, Spray C

This is a review of current guidelines for diagnosing and managing idiopathic constipation in children.

Systematic reviews English (10) French All (10)

Cochrane Systematic Review: Osmotic and stimulant laxatives for the management of childhood constipation

Visit

Gordon M, MacDonald JK, Parker CE, Akobeng AK, Thomas AG

The objective of this systematic review was to evaluate the efficacy and safety of osmotic and stimulant laxatives used to treat functional childhood constipation.

Systematic Review: Is There A Role for Pre-, Pro- and Synbiotics in the Treatment of Functional Constipation in Children?

Visit

Koppen IJ, Benninga MA, Tabbers MM

The objective of this systematic review was to investigate the efficacy and safety of pre-, pro- and synbiotics in the treatment of pediatric functional constipation.

Review: Management of Functional Constipation in Children: Therapy in Practice

Visit

Koppen IJ, Lammers LA, Benninga MA, Tabbers MM

This review discusses the evaluation and management of functional constipation in the pediatric population and provides a summary of drug treatment options.

Systematic Review: Constipation in children: fibre and probiotics

Visit

Tabbers MM, Benninga MA

This systematic review aimed to answer the following clinical questions: What are the effects of fibre for children with chronic constipation? What are the effects of probiotics for children with chronic constipation?

Review: Irritable bowel syndrome in children: pathogenesis, diagnosis and evidence-based treatment

Visit

Sandhu BK, Paul SP

This review covers the description, etiology, diagnosis and management of irritable bowel syndrome in children.

Cochrane Systematic Review: Behavioural and cognitive interventions with or without other treatments for the management of faecal incontinence in children

Visit

Brazzelli M, Griffiths PV, Cody JD, Tappin D

The objective of this systematic review was to assess the effects of behavioural and/or cognitive interventions for the management of faecal incontinence in children.

Systematic Review: Nonpharmacologic treatments for childhood constipation: systematic review

Visit

Tabbers MM, Boluyt N, Berger MY, Benninga MA

The objectives of this systematic review were to summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine.

Systematic Review: Constipation in children

Visit

Tabbers MM, Boluyt N, Berger MY, Benninga MA

This systematic review aimed to answer the following clinical questions: What are the effects of treatments for children with chronic constipation? What are the effects of treatments for clearing the bowel in children with faecal impaction?

Review: Clinical practice guidelines for pediatric constipation

Visit

Greenwald BJ

The purpose of this review was to discuss the diagnosis and management of pediatric constipation by nurse practitioners in primary care.

Systematic Review: Currently recommended treatments of childhood constipation are not evidence based: a systematic literature review on the effect of laxative treatment and dietary measures

Visit

Pijpers MA, Tabbers MM, Benninga MA, Berger MY

The objective of this systematic review was to investigate and summarise the quantity and quality of the current evidence for the effect of laxatives and dietary measures on functional childhood constipation.

Cochrane Systematic Review: Osmotic and stimulant laxatives for the management of childhood constipation

Visit

Gordon M, MacDonald JK, Parker CE, Akobeng AK, Thomas AG

The objective of this systematic review was to evaluate the efficacy and safety of osmotic and stimulant laxatives used to treat functional childhood constipation.

Systematic Review: Is There A Role for Pre-, Pro- and Synbiotics in the Treatment of Functional Constipation in Children?

Visit

Koppen IJ, Benninga MA, Tabbers MM

The objective of this systematic review was to investigate the efficacy and safety of pre-, pro- and synbiotics in the treatment of pediatric functional constipation.

Review: Management of Functional Constipation in Children: Therapy in Practice

Visit

Koppen IJ, Lammers LA, Benninga MA, Tabbers MM

This review discusses the evaluation and management of functional constipation in the pediatric population and provides a summary of drug treatment options.

Systematic Review: Constipation in children: fibre and probiotics

Visit

Tabbers MM, Benninga MA

This systematic review aimed to answer the following clinical questions: What are the effects of fibre for children with chronic constipation? What are the effects of probiotics for children with chronic constipation?

Review: Irritable bowel syndrome in children: pathogenesis, diagnosis and evidence-based treatment

Visit

Sandhu BK, Paul SP

This review covers the description, etiology, diagnosis and management of irritable bowel syndrome in children.

Cochrane Systematic Review: Behavioural and cognitive interventions with or without other treatments for the management of faecal incontinence in children

Visit

Brazzelli M, Griffiths PV, Cody JD, Tappin D

The objective of this systematic review was to assess the effects of behavioural and/or cognitive interventions for the management of faecal incontinence in children.

Systematic Review: Nonpharmacologic treatments for childhood constipation: systematic review

Visit

Tabbers MM, Boluyt N, Berger MY, Benninga MA

The objectives of this systematic review were to summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine.

Systematic Review: Constipation in children

Visit

Tabbers MM, Boluyt N, Berger MY, Benninga MA

This systematic review aimed to answer the following clinical questions: What are the effects of treatments for children with chronic constipation? What are the effects of treatments for clearing the bowel in children with faecal impaction?

Review: Clinical practice guidelines for pediatric constipation

Visit

Greenwald BJ

The purpose of this review was to discuss the diagnosis and management of pediatric constipation by nurse practitioners in primary care.

Systematic Review: Currently recommended treatments of childhood constipation are not evidence based: a systematic literature review on the effect of laxative treatment and dietary measures

Visit

Pijpers MA, Tabbers MM, Benninga MA, Berger MY

The objective of this systematic review was to investigate and summarise the quantity and quality of the current evidence for the effect of laxatives and dietary measures on functional childhood constipation.

Key studies English (25) French All (25)

Key Study: Delayed Diagnoses in Children with Constipation: Multicenter Retrospective Cohort Study

Visit

Freedman SB, Rodean J, Hall M, Alpern ER, Aronson PL, Simon HK, Shah SS, Mari...

The objective of this study was to evaluate the association between abdominal radiograph performance and emergency department (ED) revisits with important alternate diagnosis among children with constipation.

Key Study: Effectiveness of Pelvic Physiotherapy in Children With Functional Constipation Compared With Standard Medical Care

Visit

van Engelenburg-van Lonkhuyzen ML, Bols EM, Benninga MA, Verwijs WA, de Bie RA

This study aimed to compare the effectiveness of pelvic physiotherapy (PPT) vs standard medical care (SMC) in children with functional constipation.

Key Study: Using the Bristol Stool Scale and Parental Report of Stool Consistency as Part of the Rome III Criteria for Functional Constipation in Infants and Toddlers

Visit

Koppen IJ, Velasco-Benitez CA, Benninga MA, Di Lorenzo C, Saps M

The objectives of this study were to evaluate among parents of infants and toddlers the agreement between parental report and the Bristol Stool Scale (BSS) in assessing stool consistency and the effect of both methods on determining the prevalence of functional constipation (FC) according to the Rome III criteria.

Key Study: Follow-up in Childhood Functional Constipation: A Randomized, Controlled Clinical Trial

Visit

Modin L, Walsted AM, Rittig CS, Hansen AV, Jakobsen MS

The objective of this study was to evaluate whether follow-up by phone or self-management through Web-based information improved treatment outcomes for childhood functional constipation.

Key Study: Free fatty acid suppositories are as effective as docusate sodium and sorbitol enemas in treating constipation in children

Visit

Ormarsson OT, Asgrimsdottir GM, Loftsson T, Stefansson E, Lund SH, Bjornsson ES

This phase two clinical trial evaluated the efficacy of suppositories containing free fatty acids (FFA) compared with Klyx docusate sodium and sorbitol enemas for treating constipation in children.

Key Study: Recurrent Urinary Tract Infections in Children With Bladder and Bowel Dysfunction

Visit

Shaikh N, Hoberman A, Keren R, Gotman N, Docimo SG, Mathews R, Bhatnagar S, I...

The objectives of this longitudinal study were to describe the clinical characteristics of children with bowel dysfunction and to examine the effects of bowel dysfunction on patient outcomes in children with and without vesicoureteral reflux.

Key Study: Comparison of Polyethylene Glycol-Electrolyte Solution vs Polyethylene Glycol-3350 for the Treatment of Fecal Impaction in Pediatric Patients

Visit

Boles EE, Gaines CL, Tillman EM

The objective of this study was to evaluate the safety and efficacy of polyethylene glycol-electrolyte solution vs polyethylene glycol-3350 for the treatment of fecal impaction in pediatric patients.

Key Study: Polyethylene glycol 4000 for treatment of functional constipation in children

Visit

Dziechciarz P, Horvath A, Szajewska H

The aim of the study was to evaluate the effectiveness and safety of 2 different polyethylene glycol (PEG) doses for the maintenance treatment of functional constipation in children.

Key Study: Disimpaction of children with severe constipation in 3-4 days in a suburban clinic using polyethylene glycol with electrolytes and sodium picosulphate

Visit

Jordan-Ely J, Hutson JM, Southwell BR

The aim of this study was to assess the effectiveness of a high-dose oral protocol using polyethylene glycol with electrolytes (PEG + E) (Movicol Rx) combined with sodium picosulphate (SP) (Dulcolax SP Rx) in faecal impaction in children presenting to a suburban clinic.

Key Study: PedsQL Gastrointestinal Symptoms Scales and Gastrointestinal Worry Scales in pediatric patients with functional and organic gastrointestinal diseases in comparison to healthy controls

Visit

Varni JW, Bendo CB, Denham J, Shulman RJ, Self MM, Neigut DA, Nurko S, Patel ...

The primary objective of this study was to compare the gastrointestinal (GI) symptoms and worry of pediatric patients with functional GI disorders (FGIDs) and organic GI diseases to healthy controls utilizing the Pediatric Quality of Life Inventor (PedsQL) Gastrointestinal Symptoms and Worry Scales for patient self-reports ages 5-18 years and parent proxy-reports for ages 2-18 years. The secondary objective was to compare FGIDs and organic GI diseases to each other.

Key Study: Safety and efficacy of milk and molasses enemas in the emergency department

Visit

Vilke GM, DeMers G, Patel N, Castillo EM

The objective of this study was to evaluate the success and complication rates of administering milk and molasses enemas in the ED.

Key Study: Pediatric abdominal radiograph use, constipation, and significant misdiagnoses

Visit

Freedman SB, Thull-Freedman J, Manson D, Rowe MF, Rumantir M, Eltorki M, Schuh S

The objectives of this study were to determine the proportion of children diagnosed with constipation assigned a significant alternative diagnosis within 7 days (misdiagnosis), if there was an association between abdominal radiograph (AXR) performance and misdiagnosis, and if there were features that might identify children with misdiagnoses.

Key Study: Pediatric constipation in the emergency department: evaluation, treatment, and outcomes

Visit

Freedman SB, Thull-Freedman J, Rumantir M, Eltorki M, Schuh S

The primary objective of this study was to determine whether enema administration is associated with 7-day emergency department (ED) revisits for persistent symptoms of pediatric constipation. Secondary objectives focused on assessing other predictors of ED revisits.

Key Study: Prucalopride is no more effective than placebo for children with functional constipation

Visit

Mugie SM, Korczowski B, Bodi P, Green A, Kerstens R, Ausma J, Ruth M, Levine ...

This multicenter, randomized, placebo-controlled, double-blind, phase 3 trial aimed to evaluate the efficacy and safety of prucalopride in children (6 months to 18 years old) with functional constipation.

Key Study: A randomized trial of enemaversus polyethylene glycol 3350 for fecal disimpaction in children presenting to an emergency department

Visit

Miller MK, Dowd MD, Friesen CA, Walsh-Kelly CM

This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment.

Key Study: Safety and efficacy of milk and molasses enemas compared with sodium phosphate enemas for the treatment of constipation in a pediatric emergency department

Visit

Hansen SE, Whitehill JL, Goto CS, Quintero CA, Darling BE, Davis J

The purpose of this study was to determine the safety and efficacy of routine milk and molasses enemas (MME) compared with sodium phosphate enemas for the treatment of constipation in the pediatric emergency department (ED). A secondary objective included the identification of factors associated with enema selection in the pediatric ED.

Key Study: Rectal fecal impaction treatment in childhood constipation: enemas versus high doses oral PEG

Visit

Bekkali NL, van den Berg MM, Dijkgraaf MG, van Wijk MP, Bongers ME, Liem O, B...

This study tested the hypothesis that enemas and polyethylene glycol (PEG) would be equally effective in treating rectal fecal impaction (RFI) but enemas would be less well tolerated and colonic transit time (CTT) would improve during disimpaction.

Key Study: A randomized controlled trial of enemas in combination with oral laxative therapy for children with chronic constipation

Visit

Bongers ME, van den Berg MM, Reitsma JB, Voskuijl WP, Benninga MA

This randomized controlled trial compared the effects of additional treatment with rectal enemas (intervention) with conventional treatment alone (oral laxatives, control) in severely constipated children.

Key Study: PEG3350 in the treatment of childhood constipation: a multicenter, double-blinded, placebo-controlled trial

Visit

Nurko S, Youssef NN, Sabri M, Langseder A, McGowan J, Cleveland M, Di Lorenzo C

This study aimed to establish the efficacy and best starting dose of polyethylene glycol (PEG)3350 in the short-term treatment of children with functional constipation.

Key Study: Behavioral therapy for childhood constipation: a randomized, controlled trial

Visit

van Dijk M, Bongers ME, de Vries GJ, Grootenhuis MA, Last BF, Benninga MA

The aim of this study was to evaluate the clinical effectiveness of behavioral therapy with laxatives compared with conventional treatment in treating functional constipation in childhood.

Key Study: Functional defecation disorders in children: PACCT criteria versus Rome II criteria

Visit

Boccia G, Manguso F, Coccorullo P, Masi P, Pensabene L, Staiano A

The aim of this study was to evaluate the clinical validity and applicability of the Paris Consensus on Childhood Constipation Terminology (PACCT) versus the Rome II criteria for pediatric functional defecation disorders (FDDs).

Key Study: Emergency department management and short-term outcome of children with constipation

Visit

Miller MK, Dowd MD, Fraker M

The objective of this study was to describe variation in emergency department evaluation and treatment of children with constipation and characteristics and treatments associated with improvement.

Key Study: Polyethylene glycol 3350 plus electrolytes for chronic constipation in children: a double blind, placebo controlled, crossover study

Visit

Thomson MA, Jenkins HR, Bisset WM, Heuschkel R, Kalra DS, Green MR, Wilson DC...

The objective of this study were to assess the efficacy and safety of polyethylene glycol 3350 plus electrolytes (PEG+E) for the treatment of chronic constipation in children.

Key Study: A randomized, prospective, comparison study of polyethylene glycol 3350 without electrolytes and milk of magnesia for children with constipation and fecal incontinence

Visit

Loening-Baucke V, Pashankar DS

The aim of this study was to compare 2 laxatives, namely, polyethylene glycol 3350 without electrolytes and milk of magnesia, evaluating the efficacy, safety, acceptance, and 1-year outcomes.

Key Study: Predictive factors for short-term symptom persistence in children after emergency department evaluation for constipation

Visit

Patel H, Law A, Gouin S

The objectives of this study were to describe the clinical characteristics of children presenting to the ED with constipation and the ED interventions; to measure short-term symptom resolution at 48 hours and 7 days after the ED visit; and to identify predictive factors associated with poor symptom resolution at 48 hours and 7 days after the ED visit.

Key Study: Delayed Diagnoses in Children with Constipation: Multicenter Retrospective Cohort Study

Visit

Freedman SB, Rodean J, Hall M, Alpern ER, Aronson PL, Simon HK, Shah SS, Mari...

The objective of this study was to evaluate the association between abdominal radiograph performance and emergency department (ED) revisits with important alternate diagnosis among children with constipation.

Key Study: Effectiveness of Pelvic Physiotherapy in Children With Functional Constipation Compared With Standard Medical Care

Visit

van Engelenburg-van Lonkhuyzen ML, Bols EM, Benninga MA, Verwijs WA, de Bie RA

This study aimed to compare the effectiveness of pelvic physiotherapy (PPT) vs standard medical care (SMC) in children with functional constipation.

Key Study: Using the Bristol Stool Scale and Parental Report of Stool Consistency as Part of the Rome III Criteria for Functional Constipation in Infants and Toddlers

Visit

Koppen IJ, Velasco-Benitez CA, Benninga MA, Di Lorenzo C, Saps M

The objectives of this study were to evaluate among parents of infants and toddlers the agreement between parental report and the Bristol Stool Scale (BSS) in assessing stool consistency and the effect of both methods on determining the prevalence of functional constipation (FC) according to the Rome III criteria.

Key Study: Follow-up in Childhood Functional Constipation: A Randomized, Controlled Clinical Trial

Visit

Modin L, Walsted AM, Rittig CS, Hansen AV, Jakobsen MS

The objective of this study was to evaluate whether follow-up by phone or self-management through Web-based information improved treatment outcomes for childhood functional constipation.

Key Study: Free fatty acid suppositories are as effective as docusate sodium and sorbitol enemas in treating constipation in children

Visit

Ormarsson OT, Asgrimsdottir GM, Loftsson T, Stefansson E, Lund SH, Bjornsson ES

This phase two clinical trial evaluated the efficacy of suppositories containing free fatty acids (FFA) compared with Klyx docusate sodium and sorbitol enemas for treating constipation in children.

Key Study: Recurrent Urinary Tract Infections in Children With Bladder and Bowel Dysfunction

Visit

Shaikh N, Hoberman A, Keren R, Gotman N, Docimo SG, Mathews R, Bhatnagar S, I...

The objectives of this longitudinal study were to describe the clinical characteristics of children with bowel dysfunction and to examine the effects of bowel dysfunction on patient outcomes in children with and without vesicoureteral reflux.

Key Study: Comparison of Polyethylene Glycol-Electrolyte Solution vs Polyethylene Glycol-3350 for the Treatment of Fecal Impaction in Pediatric Patients

Visit

Boles EE, Gaines CL, Tillman EM

The objective of this study was to evaluate the safety and efficacy of polyethylene glycol-electrolyte solution vs polyethylene glycol-3350 for the treatment of fecal impaction in pediatric patients.

Key Study: Polyethylene glycol 4000 for treatment of functional constipation in children

Visit

Dziechciarz P, Horvath A, Szajewska H

The aim of the study was to evaluate the effectiveness and safety of 2 different polyethylene glycol (PEG) doses for the maintenance treatment of functional constipation in children.

Key Study: Disimpaction of children with severe constipation in 3-4 days in a suburban clinic using polyethylene glycol with electrolytes and sodium picosulphate

Visit

Jordan-Ely J, Hutson JM, Southwell BR

The aim of this study was to assess the effectiveness of a high-dose oral protocol using polyethylene glycol with electrolytes (PEG + E) (Movicol Rx) combined with sodium picosulphate (SP) (Dulcolax SP Rx) in faecal impaction in children presenting to a suburban clinic.

Key Study: PedsQL Gastrointestinal Symptoms Scales and Gastrointestinal Worry Scales in pediatric patients with functional and organic gastrointestinal diseases in comparison to healthy controls

Visit

Varni JW, Bendo CB, Denham J, Shulman RJ, Self MM, Neigut DA, Nurko S, Patel ...

The primary objective of this study was to compare the gastrointestinal (GI) symptoms and worry of pediatric patients with functional GI disorders (FGIDs) and organic GI diseases to healthy controls utilizing the Pediatric Quality of Life Inventor (PedsQL) Gastrointestinal Symptoms and Worry Scales for patient self-reports ages 5-18 years and parent proxy-reports for ages 2-18 years. The secondary objective was to compare FGIDs and organic GI diseases to each other.

Key Study: Safety and efficacy of milk and molasses enemas in the emergency department

Visit

Vilke GM, DeMers G, Patel N, Castillo EM

The objective of this study was to evaluate the success and complication rates of administering milk and molasses enemas in the ED.

Key Study: Pediatric abdominal radiograph use, constipation, and significant misdiagnoses

Visit

Freedman SB, Thull-Freedman J, Manson D, Rowe MF, Rumantir M, Eltorki M, Schuh S

The objectives of this study were to determine the proportion of children diagnosed with constipation assigned a significant alternative diagnosis within 7 days (misdiagnosis), if there was an association between abdominal radiograph (AXR) performance and misdiagnosis, and if there were features that might identify children with misdiagnoses.

Key Study: Pediatric constipation in the emergency department: evaluation, treatment, and outcomes

Visit

Freedman SB, Thull-Freedman J, Rumantir M, Eltorki M, Schuh S

The primary objective of this study was to determine whether enema administration is associated with 7-day emergency department (ED) revisits for persistent symptoms of pediatric constipation. Secondary objectives focused on assessing other predictors of ED revisits.

Key Study: Prucalopride is no more effective than placebo for children with functional constipation

Visit

Mugie SM, Korczowski B, Bodi P, Green A, Kerstens R, Ausma J, Ruth M, Levine ...

This multicenter, randomized, placebo-controlled, double-blind, phase 3 trial aimed to evaluate the efficacy and safety of prucalopride in children (6 months to 18 years old) with functional constipation.

Key Study: A randomized trial of enemaversus polyethylene glycol 3350 for fecal disimpaction in children presenting to an emergency department

Visit

Miller MK, Dowd MD, Friesen CA, Walsh-Kelly CM

This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment.

Key Study: Safety and efficacy of milk and molasses enemas compared with sodium phosphate enemas for the treatment of constipation in a pediatric emergency department

Visit

Hansen SE, Whitehill JL, Goto CS, Quintero CA, Darling BE, Davis J

The purpose of this study was to determine the safety and efficacy of routine milk and molasses enemas (MME) compared with sodium phosphate enemas for the treatment of constipation in the pediatric emergency department (ED). A secondary objective included the identification of factors associated with enema selection in the pediatric ED.

Key Study: Rectal fecal impaction treatment in childhood constipation: enemas versus high doses oral PEG

Visit

Bekkali NL, van den Berg MM, Dijkgraaf MG, van Wijk MP, Bongers ME, Liem O, B...

This study tested the hypothesis that enemas and polyethylene glycol (PEG) would be equally effective in treating rectal fecal impaction (RFI) but enemas would be less well tolerated and colonic transit time (CTT) would improve during disimpaction.

Key Study: A randomized controlled trial of enemas in combination with oral laxative therapy for children with chronic constipation

Visit

Bongers ME, van den Berg MM, Reitsma JB, Voskuijl WP, Benninga MA

This randomized controlled trial compared the effects of additional treatment with rectal enemas (intervention) with conventional treatment alone (oral laxatives, control) in severely constipated children.

Key Study: PEG3350 in the treatment of childhood constipation: a multicenter, double-blinded, placebo-controlled trial

Visit

Nurko S, Youssef NN, Sabri M, Langseder A, McGowan J, Cleveland M, Di Lorenzo C

This study aimed to establish the efficacy and best starting dose of polyethylene glycol (PEG)3350 in the short-term treatment of children with functional constipation.

Key Study: Behavioral therapy for childhood constipation: a randomized, controlled trial

Visit

van Dijk M, Bongers ME, de Vries GJ, Grootenhuis MA, Last BF, Benninga MA

The aim of this study was to evaluate the clinical effectiveness of behavioral therapy with laxatives compared with conventional treatment in treating functional constipation in childhood.

Key Study: Functional defecation disorders in children: PACCT criteria versus Rome II criteria

Visit

Boccia G, Manguso F, Coccorullo P, Masi P, Pensabene L, Staiano A

The aim of this study was to evaluate the clinical validity and applicability of the Paris Consensus on Childhood Constipation Terminology (PACCT) versus the Rome II criteria for pediatric functional defecation disorders (FDDs).

Key Study: Emergency department management and short-term outcome of children with constipation

Visit

Miller MK, Dowd MD, Fraker M

The objective of this study was to describe variation in emergency department evaluation and treatment of children with constipation and characteristics and treatments associated with improvement.

Key Study: Polyethylene glycol 3350 plus electrolytes for chronic constipation in children: a double blind, placebo controlled, crossover study

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Thomson MA, Jenkins HR, Bisset WM, Heuschkel R, Kalra DS, Green MR, Wilson DC...

The objective of this study were to assess the efficacy and safety of polyethylene glycol 3350 plus electrolytes (PEG+E) for the treatment of chronic constipation in children.

Key Study: A randomized, prospective, comparison study of polyethylene glycol 3350 without electrolytes and milk of magnesia for children with constipation and fecal incontinence

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Loening-Baucke V, Pashankar DS

The aim of this study was to compare 2 laxatives, namely, polyethylene glycol 3350 without electrolytes and milk of magnesia, evaluating the efficacy, safety, acceptance, and 1-year outcomes.

Key Study: Predictive factors for short-term symptom persistence in children after emergency department evaluation for constipation

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Patel H, Law A, Gouin S

The objectives of this study were to describe the clinical characteristics of children presenting to the ED with constipation and the ED interventions; to measure short-term symptom resolution at 48 hours and 7 days after the ED visit; and to identify predictive factors associated with poor symptom resolution at 48 hours and 7 days after the ED visit.