In a review of 538 children with functional constipation, we analyzed ages of presentation and onset, symptom duration, and behavioral/developmental problems. We divided the subjects into quartiles (Q1-Q4) based on age of onset. Median onset age was 2.3 years. The oldest group had the shortest symptom duration before referral at 1.8 ± 1.8 years (compared with Q3 to Q1, P = 0.039, P = 0.001, P < 0.001, respectively). Of the Q4 subjects, 22% had a behavioral/developmental problem (P < 0.001 compared with Q1-Q3). We conclude that most children develop functional constipation as infants and toddlers, but those with later onset are more likely to have behavioral/developmental issues and see a specialist sooner.

Objectives The aim of this study was to determine if concomitant gastroparesis and biliary dyskinesia occur in children, and if so, to determine if concomitant gastroparesis affects clinical outcome in children with biliary dyskinesia. Methods: We conducted a retrospective chart review of children with biliary dyskinesia (ejection fraction <35% on cholescintigraphy, with no other metabolic, or structural cause) who completed a solid-phase gastric emptying scintigraphy scan within 12 months of the abnormal cholescintigraphy. Children were classified into one of four clinical outcome groups (excellent, good, fair, poor). Results Thirty-five children with a mean follow-up time of 23.1 ± 17.3 (SD) months were included. 20 (57%) children were identified as having concomitant gastroparesis with biliary dyskinesia. Children with concomitant gastroparesis were more likely to have a poor clinical outcome compared to those with biliary dyskinesia alone (P<0.005). In children undergoing cholecystectomy, those with concomitant gastroparesis were more likely to have a fair or poor clinical outcome compared to those with biliary dyskinesia alone (P<0.01). Factors predicting a more favorable clinical outcome were having biliary dyskinesia alone, and not having limitations in activity (e.g. school absences) at time of presentation. Conclusions Concomitant gastroparesis may occur in children with functional gallbladder disorders. Concomitant gastroparesis may negatively impact clinical outcome in children with biliary dyskinesia.

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