Proposals to Approximate the Pediatric Rome Constipation Criteria to Everyday Practice

Abstract

For diagnosis and treatment of pediatric constipation in primary care, one constipation sign/symptom should suffice. The recommended daily dietary fiber intake, according to the American Health Foundation, should be detailed as a treatment measure, and also for prevention, from weaning on.

In Vitro Hydrogen Production by Enteric Bacteria Cultured from Children with Small Bowel Bacterial Overgrowth

“…Low colonic pH may have contributed to in vivo non-H, production in some children, secondary to diet, acute diarrhea, or chronic carbohydrate malabsorption. Reduced breath Hz responses have been reported in children with acute gastroenteritis and clinical monosaccharide intolerance (22,23), and we have recently identified a high prevalence of rice carbohydrate malabsorption in Burmese village children (7,8), conditions which generally produce acidic fecal contents (15,24). Our findings suggest that some enteric bacteria associated with small bowel overgrowth may not be capable of producing Hz (at least in the in vitro system used).…”

Prevalence of constipation in cystic fibrosis patients: a systematic review of observational studies

“… 22 Constipation, as a nosological entity, is defined by the presence of clinical manifestations. 23 However, among the proposed definition of symptoms required to diagnose constipation, no definition or proposed set of criteria is comprehensive enough to identify all patients suffering from this condition in clinical practice. The lack of a comprehensive consensus definition impairs not only clinical practice, but also epidemiological conclusions or comparisons and, particularly, the inclusion of subjects into clinical studies.…”

“…According to Littlewood, 23 in addition to history and physical exam, abdominal radiography would be useful not only for diagnosis, but also for evaluation of the therapeutic result. The ESPGHAN 12 and CFF 25 definitions agree with the presence of excessive fecal retention in the large intestine, but performing a simple abdominal radiography to diagnose and manage constipation and fecal retention is not a consensus recommendation among the authors.…”

Too Much Information. What to Do?

“…There are current themes that deserve attention from the specialist such as intestinal constipation, swallowing, diagnostic methods of gastroesophageal reflux, proton pump inhibitors, achalasia, anorectal function evaluation. The edition consists of four reviews/updates with critical analysis of the literature (1)(2)(3)(4) and nine original works of research/standardization of study methods (5)(6)(7)(8)(9)(10)(11)(12)(13) . Particularly draws attention the medical centers involved (Faculdade .…”