Treatment Guideline Chart

Constipation is a delay or difficulty in bowel movement persisting for ≥2 weeks.
It is a common digestive problem, not a disease, and usually not serious caused by changes in diet and early toilet training.
Constipation in children generally first happens in the toddler stage, between ages 2 and 4 years, with studies showing variation in gender-specific prevalence.
Functional constipation is  the one that cannot be explained by any anatomical, physiological, radiological or histological abnormalities.
Organic constipation is with identifiable physiological or organic cause.
Chronic constipation is the constipation that lasts for >8 weeks.

Constipation in Children References

  1. Biggs WS, Dery WH. Evaluation and treatment of constipation in infants and children. Am Fam Physician. 2006 Feb;73(3):469-477. PMID: 16477894
  2. Rowan-Legg A; Canadian Paediatric Society, Community Paediatrics Committee. Managing functional constipation in children. Paedtr Child Health. 2011 Dec;16(10):661-670. PMID: 23204909
  3. Greenwald BJ. Clinical practice guidelines for pediatric constipation. Journal of the American Academy of Nurse Practitioners. 2010 Jul;22(7):332-338. PMID: 20590953
  4. Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology & Nutrition. Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Journal of Pediatric Gastroenterology and Nutrition. 2006 Sep;43(3):e1-e13. PMID: 16954945
  5. Rajindrajith S, Devanarayana NM. Constipation in children: Novel insight into epidemiology, pathophysiology, and management. J Neurogastroenterol Motil. 2011 Jan;17(1):35-47. doi: 10.5056/jnm.2011.17.1.35. PMID: 21369490
  6. Gartlehner G, Jonas DE, Morgan LC, et al. Drug class review on constipation drugs. Portland: Oregon Health & Science University; 2007.
  7. MedWorm
  8. MedWorm
  9. Mayo Clinic Staff. Constipation in Children. Mayo Clinic Web Site. Aug 2011. Accessed 04 Apr 2013.
  10. Family editorial staff. Constipation. Family Web Site. Aug 2012. Accessed 04 Apr 2013.
  11. Basson MD. Constipation medication. Medscape Web Site. Aug 2012. Accessed 07 Apr 2013.
  12. PEG-3350 and Electrolytes powder solution. Daily Med. Oct 2009. Accessed 12 Apr 2013
  13. Borowitz S. Pediatric constipation clinical presentation. Medscape Web Site. Feb 2013. Accessed 04 Apr 2013.
  14. World Gastroenterology Organisation. World Gastroenterology Organisation Practice Guidelines: Constipation. World Gastroenterology Organization Web Site. 2007. Accessed 04 Apr 2013.
  15. National Digestive Diseases Information Clearinghouse (NDDIC). Constipation in children. NDDIC Web Site. http://digestive.niddk.nih. gov/ddiseases/pubs/constipationchild/. Aug 2013. Accessed 31 Mar 2014.
  16. National Institute for Health and Clinical Excellence. Constipation in children and young people: diagnosis and management of idiopathic childhood constipation in primary and secondary care. National Institute for Health and Care Excellence (NICE) Web Site. May 2010.
  17. Sood MR. Chronic functional constipation and fecal incontinence in infants and children: Treatment. UptoDate website. Jan 2015.
  18. Tabbers MM, DiLorenzo C, Berger MY, et al; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; North American Society for Pediatric Gastroenterology. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 2014 Feb;58(2):258-274. PMID: 24345831
  19. Rome Foundation. What's new for Rome IV. Rome Foundation. 2016.
  20. Schmulson MJ, Drossman DA. What Is new in Rome IV. J Neurogastroenterol Motil. 2017 Apr;23(2):151-163. doi: 10.5056/jnm16214. PMID: 28274109
  21. Simren M, Palsson OS, Whitehead WE. Update on Rome IV criteria for colorectal disorders: Implications for clinical practice. Curr gastroenterol Rep. 2017 Apr;19(4):15. doi: 10.1007/s11894-017-0554-0. PMID: 28374308
  22. Zeevenhooven J, Koppen IJ, Benninga MA. The New Rome IV Criteria for functional gastrointestinal disorders in infants and toddlers. Pediatr Gastroenterol Hepatol Nutr. 2017 Mar;20(1):1-13. doi: 10.5223/pghn.2017.20.1.1. PMID: 28401050
  23. Benninga MA, Faure C, Hyman PE, St James Roberts I, Schechter NL, Nurko S. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology. 2016 Feb. pii: S0016-5085(16)00182-7. PMID: 27144631
  24. Indian Society Of Pediatric Gastroenterology, Hepatology And Nutrition Committee On Childhood Functional Constipation And Pediatric Gastroenterology Subspecialty Chapter Of Indian Academy Of Pediatrics, Yachha SK, Srivastava A, Mohan N, Bharadia L, Sarma MS. Management of childhood functional constipation: Consensus practice guidelines of Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition and Pediatric Gastroenterology Chapter of Indian Academy of Pediatrics. Jun 13, 2018. Indian Pediatr. pii: S097475591600121. PMID: 29941697
  25. Sood MR. Chronic functional constipation and fecal incontinence in infants and children: treatment. UpToDate. May 2018.
  26. Tambucci R, Quitadamo P, Thapar N, et al. Diagnostic tests in pediatric constipation. J Pediatr Gastroenterol Nutr. 2018 Apr;66(4):e89-e98. doi: 10.1097/MPG.0000000000001874. PMID: 29287015
  27. Sood MR. Recent-onset constipation in infants and children. UpToDate. Jan 2019.
  28. Turner TL, Matlock KB. Toilet training. UpToDate. May 2019.
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