Dietary treatments for childhood constipation: efficacy of dietary fiber and whole grains
ABSTRACT Constipation in children is defined on the basis of several clusters of symptoms, and these symptoms are likely to persist into adulthood. The aim of this review article is to summarize the current literature on the use of dietary fiber and whole grains as treatments for childhood constipation. Current recommendations for fiber intake in children vary substantially among organizations, suggesting that the function of fiber in children is not fully understood. Additionally, no formal definition of "whole grain" exists, which further complicates the interpretation of the literature. Few randomized controlled trials have examined the effect of dietary fiber supplementation in children with constipation. Currently, no randomized controlled trials have investigated the efficacy of whole grains in treating childhood constipation. This is an area that warrants further attention. Increasing the intake of dietary fiber and/or whole grain has the potential to relieve childhood constipation; however, additional randomized controlled trials are necessary to make a formal recommendation.
Article: Control issues in toilet training[Show abstract] [Hide abstract]
ABSTRACT: There are many control issues surrounding toilet training that involve the child, the family, and the environment. Loss of control by the child during this period can result in significant physical and psychologic consequences as well as a failure to complete the developmental task of autonomy. A review of both professional and lay literature showed various approaches to toilet training with little reference to the control issues involved. Toilet training is a dynamic process that does not always go smoothly. Constipation often develops during toilet training and may be related to control issues. Neuman's Systems Model is used to identify the types of control issues often involved in toilet training. Anticipatory guidance specifically developed to address issues of control may help alleviate problems in the toilet training process. Changes for current practice are recommended.Pediatric nursing 01/2000; 26(3):267-72.
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ABSTRACT: To examine what factors were associated with functional constipation amongst primary school students. Constipation in school-age children has also been brought to the attention of health care researchers because this requires long-term therapy. The prognosis of functional constipation is vague because it has many causative factors. In fact, the focus on constipation in the health care system is always placed on medical management, rather than prevention. A descriptive survey. The survey was conducted on March 2008 at one primary school in Hong Kong; 383 children who are studying in primary 3-5 aged from 8-10 completed a questionnaire. Three main outcome variables were employed in the study: demographic, constipation assessment scale and dietary and environmental factors. There were 7.3% students with functional constipation. Students who were age ∼10 (p<0.001), with a total daily fluid intake (200 ml/cup) of 3-4 cups (p<0.001) or +5 cups (p<0.001) and preference for eating fruit and vegetables (p<0.001) were less likely to have functional constipation. The findings should aid paediatric health care professionals and parents to gain a more profound understanding of the nature and prevention of functional constipation. To help primary school students and their parents to cope with functional constipation, greater familiarity with its prevalence and the characteristics of its contributory factors is needed. It is hoped that this could providing a better understanding and awareness of this issue and that it will encourage setting up strategies to decrease the morbidity and diminish the negative consequences of functional constipation for primary school students. Nurses can act as advocators for primary school students, parents and school teachers in understanding and preventing functional constipation.Journal of Clinical Nursing 10/2010; 19(23-24):3390-400. DOI:10.1111/j.1365-2702.2010.03362.x · 1.26 Impact Factor
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ABSTRACT: The Rome II pediatric criteria for functional gastrointestinal disorders (FGIDs) were defined in 1999 to be used as diagnostic tools and to advance empirical research. In this document, the Rome III Committee aimed to update and revise the pediatric criteria. The decision-making process to define Rome III criteria for children aged 4-18 years consisted of arriving at a consensus based on clinical experience and review of the literature. Whenever possible, changes in the criteria were evidence based. Otherwise, clinical experience was used when deemed necessary. Few publications addressing Rome II criteria were available to guide the committee. The clinical entities addressed include (1) cyclic vomiting syndrome, rumination, and aerophagia; 2) abdominal pain-related FGIDs including functional dyspepsia, irritable bowel syndrome, abdominal migraine, and functional abdominal pain; and (3) functional constipation and non-retentive fecal incontinence. Adolescent rumination and functional constipation are newly defined for this age group, and the previously designated functional fecal retention is now included in functional constipation. Other notable changes from Rome II to Rome III criteria include the decrease from 3 to 2 months in required symptom duration for noncyclic disorders and the modification of the criteria for functional abdominal pain. The Rome III child and adolescent criteria represent an evolution from Rome II and should prove useful for both clinicians and researchers dealing with childhood FGIDs. The future availability of additional evidence-based data will likely continue to modify pediatric criteria for FGIDs.Gastroenterology 05/2006; 130(5):1527-37. DOI:10.1053/j.gastro.2005.08.063 · 13.93 Impact Factor