Abstract
Defecation disorders are common in children and adolescents. These individuals can have an impairment in quality of life and families seek medical professionals more often compared with healthy controls. Characterization of childhood and adolescent defecation disorders has evolved, and recently the disorders were included in Rome IV consensus. This consensus defines criteria and reviews the epidemiology pathophysiology and management of functional constipation and nonretentive fecal incontinence.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Di Lorenzo C. Pediatric anorectal disorders. Gastroenterol Clin N Am. 2001;30(1):269–87.
Zeevenhooven J, Koppen IJN, Benninga MA. The new Rome IV criteria for functional gastrointestinal disorders in children and toddlers. Pediatr Gastroenterol Hepatol Nutr. 2017;20(1):1–13.
Rao SCS, Bharucha AE, Chiaroni G, Felt-Bersma R, Knowles C, Malcolm A, Wald A. Anorectal disorders. Gastroenterology. 2016;150:1430–42.
Hyams JS, Di Lorenzo C, Saps M, Shulman RJ, Staiano A, van Tiburg M. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology. 2016;150:1456–68.
Lewis LL, Palsson OS, Whitehead WE, Tilburg MAL. Prevalence of functional gastrointestinal disorders in children and adolescents. J Pediatr. 2016;177:39–43.
Zaslavsky C, Ávila ED, Araújo MA, Pontes MRN, Lima EN. Intestinal constipation in childhood- a prevalence study. Revista AMRIGS. 1988;32:100–2.
Stewart WF, Liberman JN, Sandler RS, Woods MS, Stemhagena A, Chee E, et al. Epidemiology of constipation (EPOC) – study in the United States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol. 1999;94(12):3530–40.
Rajindrajith S, Devanarayana NM, Benninga MA. Review article: faecal incontinence in children: epidemiology, pathophysiology, clinical evaluation and management. Aliment Pharmacol Ther. 2013;37(1):37–4.
Zaslavsky C, Jurach MT, Barros CP. Epidemiology of anal incontinence, Porto Alegre-RS, Brasil. Revista AMRIGS. 2012;56(4):289–94.
Nurko S, Scott SM. Coexistence of constipation and incontinence in children and adults. Best Pract Res Clin Gastroenterol. 2011;25:28–41.
O’Brien MD, Phillips SF. Colonic motility in health and disease. Gastroenterol Clin N Am. 1996;25(1):147–63.
Palit S, Luniss PJ, Scott MS. Dig Dis Sci. 2012;57:1445–64.
Loening-Baucke V. Biofeedback therapy for fecal incontinence. Dig Dis Sci. 1990;8(2):112–24.
Loening-Baucke V. Constipation in early childhood: patient characteristics, treatment, and long term follow up. Gut. 1993;34(10):1400–4.
Griffiths DM. The physiology of continence: idiopathic fecal constipation and soiling. Semin Pediatr Surg. 2002;11(2):67–74.
Partin JC, Hamill SK, Fishel JE, Partin JS. Painful defecation and fecal soiling in children. Pediatrics. 1992;89(6 Pt 1):1007–9.
Baker SS, Liptak GS, Colletti RB, Croffie JM, Di Lorenzo C, Ector W, et al. Constipation in infants and children: evaluation and treatment. A medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 1999;29(5):612–26.
Morais MB, Verena HV. Intestinal constipation. J Pediatr. 2000;76(2):S147–58.
Penberthy JK. Precipitants of constipation during early childhood. J Am Board Fam Pract. 2003;16:213–8.
Hyman PE, Fleisher D. Functional fecal retention. Pract Gastroenterol. 1992;31:29–37.
Hyman PE, Milla PJ, Benninga MA, Davidson GP, Fleisher DF, Taminiau J. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology. 2006;130(5):1519–26.
Van Ginkel R, Reitsma JB, Büller MP, Van Wijk MP, Jan AJ, Taminiau M, Benninga MA. Childhood constipation: longitudinal follow-up beyond puberty. Gastroenterology. 2003;125(2):358–63.
Kovacic K, Sood MR, Mugie S, Di Lorenzo C, Nurko S, Heinz NBS, Ponnambakam A, Beesley C, Sanghavi R, Silverman AH. A multicenter study on childhood constipation and fecal incontinence: effects on quality of life. J Pediatr. 2015;166:1482–7.
Zaslavsky C, Silveira TR, Maguilnik I. Total and segmental colonic transit time with radiopaque markers in adolescents with functional constipation. J Pediatr Gastroenterol Nutr. 1998;27(2):138–42.
Benninga MA, Tabbers MM, Rijn V. How to use plain abdominal radiograph in children with functional defecation disorders. Arch Dis Child Educ Pract. 2016;101:187–93.
Loening-Baucke V. Encopresis. Curr Opin Pediatr. 2002;14:570–5.
Partin JC, Hamill SK, Fischel JE, Partin JS. Painful defecation and fecal soiling in children. Pediatrics. 1992;89(6):1007–9.
Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology. 2006;130(5):1527–37.
Benninga M, Candy DC, Catto-Smith AG, Clayden G, Loening-Baucke V, Di Lorenzo C, Nurko S, Staiano A. The Paris Consensus on Childhood Constipation Terminology (PACCT) Group. J Pediatr Gastroenterol Nutr. 2005;40(3):273–5.
Bongers ME, Voskuijl WP, van Rijn RR, Benninga MA. The value of the abdominal radiograph in children with functional gastrointestinal disorders. Eur J Radiol. 2006;59(1):8–13.
Tabbers MM, DiLorenzo C, Berger MY, Faure C, Langendam MW, Nurko S, et al. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 2014;58(2):258–74.
Rodriguez L, Sood M, Lorenzo D, Saps M. Na ANMS-NASPGHAN consensus document on anorectal and colonic manometry. Neurogastroenterol Motil. 2017;29:1–8.
Loening-Baucke V. Fecal incontinence in children. Am Fam Physician. 1997;55(6):2229–35.
Muddasani S, Moe A, Semmelrock C, Gilbert CL, Enemuo V, Chiou WH, Chumpitazi BP. Physical therapy for fecal incontinence with pelvic floor dyssynergia. J Pediatr. 2017;11:1–5.
Rajindrjith S, Devanarayana NM, Benninga MA. Fecal incontinence in adolescents is associated with child abuse, somatization, and poor health-related quality of life. J Pediatr Gastroenterol Nutr. 2016;62(5):698–703.
Mellon MW, Whiteside SP, Friedrich WN. The relevance of fecal soiling as an indicator of child sexual abuse: a preliminary analysis. J Dev Behav Pediatr. 2006;27(1):25–32.
Drossman DA. Abuse, trauma, and GI illness: is there a link? Am J Gastroenterol. 2011;106(1):14–25.
Tabbers MM, Boluyt N, Berger MY, Benninga MA. Clinical practice: diagnosis and treatment of functional constipation. Eur J Pediatr. 2011;170(8):955–63.
Vriesman MH, Velasco-Benitez CA, Ramirez CR, Benninga MA, Di Lorenzo C, Saps M. Assessing children’s report of stool consistency: agreement between the pediatric Rome III questionnaire and the Bristol Stool Scale. J Pediatr. 2017 Nov;190:69–73.
Santos JD, Lopes RI, Koyle MA. Bladder and bowel dysfunction in children: an update on the diagnosis and treatment of a common, but underdiagnosed pediatric problem. J Can Urol Assoc. 2017;11(Suppl 1):S64–72.
Zaslavsky C, Guerra TC. The Bristol Form Scale in the clinical diagnosis of constipation in in children. Rev AMRIGS. 2016;60(2):127–31.
Koppen IJN, Vriesman MH, Tabbers MM, Di Lorenzo C, Benninga MA. Awareness and implementation of the 2014 ESPGHAN/NASPGHAN guideline for childhood functional constipation. J Pediatr Gastroenterol Nutr. 2018;66(5):732–7.
Benninga MA, Buller HA, Tytgat GNJ, Akkermans MA, Bossuyt PM, Taminiau JAJM. Colonic transit time in constipated children: does pediatric slow-transit constipation exist? J Pediatr Gastroenterol Nutr. 1996;23(3):241–51.
Bautista Casasnovas A, Varela Cives R, Villanueva Jeremias A, Castro-Gago M, Cadranel S, Tojo Sierra R. Measurement of colonic transit time in children. J Pediatr Gastroenterol Nutr. 1991;13(1):42–5.
Velde SV, Notebaert A, Meersschaut V, Herregods N, Van Winckel M, Van Bierliet S. Colon transit time in healthy children and adolescents. Int J Colorectal Dis. 2013;28(12):1721–4.
Zaslavsky C, De Barros SG, Gruber AC, MacIel AC, Da Silveira TR. Chronic functional constipation in adolescents: clinical findings and motility studies. J Adolesc Health. 2004;34(6):517–22.
Belkind-Gerson J, Goldstein AM, Kuo B. Balloon expulsion test as a screen for outlet obstruction in children with chronic constipation. J Pediatr Gastroenterol Nutr. 2013;56(1):23–6.
Loening-Baucke V. Balloon defecation as a predictor of outcome in children with functional constipation and encopresis. J Pediatr. 1996;128(3):336–40.
Raghunath N, Glassman MS, Halata MS, Berezin SH, Stewart JM, Medow MS. Anorectal motility abnormalities in children with encopresis and chronic constipation. J Pediatr. 2011;158(2):293–6.
Rodriguez L, Sood M, Di Lorenzo C, Saps M. Na ANMS-NASPGHAN consensus document on anorectal and colonic manometry in children. Neurogastroenterol Motil. 2016;10:1–8.
Keshtgar AS, Ward HC, Clayden GS. Pathophysiology of chronic childhood constipation: functional and morphological evaluation by anorectal manometry and endosonography and colonic transit study. J Pediatr Surg. 2013;48(4):806–12.
Lamparyk K, Mahajan L, Debeljak A, Steffen R. Anxiety associated with high-resolution anorectal manometry in pediatric patients and parents. J Pediatr Gastroenterol Nutr. 2017;65(5):e98–e100.
Jorge JMN, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum. 1993;36(1):77–97.
Caldaro T, Romeo E, De Angelis P, Gambita RA. Three-dimensional endoanal ultrasound and anorectal manometry in children with anorectal malformations: new discoveries. J Pediatr Surg. 2012;47(5):956–63.
Infante Pina D, Segarra Cantón O, Vilalta Casas R, Pardina JC, Linan MJL, Busoms CM. Eficacia, tolerancia y seguridad a largo plazo del polietilenoglicol 3350 con eletrolitos en el tratamiento del estreñimiento functional en niños. Annales de Pediatrie. 2014;80(5):278–84.
Heikkinen M, Lindahl H, Rintala RJ. Long-term outcome after internal sphincter myectomy for internal sphincter achalasia. Pediatr Surg Int. 2005;21(2):84–7.
Sulkowski JP, Nacion MK, Deans KJ, Minneci PC, Levitt MA, Mousa HM, et al. Sacral nerve stimulation for fecal and urinary incontinence and constipation in children. J Pediatr Surg. 2015;50(10):1644–7.
Steiner SA, Torres MR, Penna FJ, Gazzinelli BF, Corradi CG, Costa AS, Ribeiro IG, de Andrade EG, do Carmo Barros de Melo M. Chronic functional constipation in children: adherence and factors associated with drug treatment. J Pediatr Gastroenterol Nutr. 2014;58(5):598–60.
Zaslavsky C, Jurach MT, Coronel AL. Anal incontinence: clinical treatment, Porto Alegre, Brazil. Rev AMRIGS. 2014;58(3):220–4.
Zaslavsky C, Loureiro RG, Jurach MT. Motivational interview in the treatment of anal incontinence. Rev AMRIGS. 2013;57(3):180–4.
MacNeily AE. Should psychological assessment be a part of incontinence management in children and adolescents? J Urol. 2016;195(5):1327–8.
Kovacic K, Sood MR, Di Lorenzo C, Nurko S, Heinz N, et al. A multicenter study on childhood constipation and fecal incontinence: effects on quality of life. J Pediatr. 2015;166(6):1482–7.
Joinson C, Heron J, Butler U, von Gotard A. Psychological differences between children with and without soiling problems. Pediatrics. 2006;117(5):1575–84.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Zaslavsky, C., Oliveira, L.C.C. (2020). Defecation Disorders in Children and Adolescents. In: Oliveira, L. (eds) Anorectal Physiology. Springer, Cham. https://doi.org/10.1007/978-3-030-43811-1_20
Download citation
DOI: https://doi.org/10.1007/978-3-030-43811-1_20
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-43810-4
Online ISBN: 978-3-030-43811-1
eBook Packages: MedicineMedicine (R0)