Emma Children's Hospital, Amsterdam Medical Center, Meigbergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Nat Rev Gastroenterol Hepatol. 2011 Aug 2;8(9):502-11. doi: 10.1038/nrgastro.2011.130.
Constipation in children is an often long-lasting pediatric functional gastrointestinal disorder with a worldwide prevalence varying between 0.7% and 29.6%, and estimated health-care costs of US$3.9 billion per year in the USA alone. The pathophysiology of childhood constipation is multifactorial and remains incompletely understood; however, withholding of stools, starting after an experience of a hard, painful, or frightening bowel movement is the most common cause found in children. A thorough medical history and physical examination, including a rectal examination in combination with a bowel diary, is sufficient in the majority of cases to diagnose constipation. The current standard treatment consists of education, toilet training, disimpaction, maintenance therapy and long-term follow-up. In the past decade, well-designed treatment trials in the pediatric population have emerged and long-term outcome studies have been completed. This Review summarizes the current knowledge of the clinical aspects of childhood constipation, including pathogenesis, diagnosis and treatment, with particular emphasis on the latest available data.
儿童便秘是一种常见的、长期存在的儿科功能性胃肠疾病，全球患病率在 0.7%至 29.6%之间，仅在美国，每年的医疗保健费用估计就达 39 亿美元。儿童便秘的病理生理学是多因素的，仍不完全清楚；然而，在经历了一次坚硬、疼痛或可怕的排便后开始憋便，是在儿童中最常见的原因。在大多数情况下，详细的病史和体格检查，包括直肠检查结合排便日记，足以诊断便秘。目前的标准治疗包括教育、如厕训练、通便、维持治疗和长期随访。在过去的十年中，已经出现了针对儿科人群的精心设计的治疗试验，并且完成了长期结局研究。本综述总结了儿童便秘的临床方面的最新知识，包括发病机制、诊断和治疗，特别强调了最新可用数据。
