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: Chronic constipation accounts for 3% to 5% of pediatric primary care outpatient visits. The most severely affected of this group develop a flaccid colon insensitive to distention, and encopresis. Laxatives and lubricants have been the standard therapeutic agents during the bowel decompression phase of encopretic therapy. Fiber has been the cornerstone of maintenance programs. Each of these agents is accompanied by considerable anxiety in the lay literature. This study evaluates the safety of combined high-fiber, laxative, and lubricant therapy on bowel movement frequency, fecal soiling, and nutritional status over a 6-month period. Blood chemistry values, dietary fiber intake, defecation pattern, and psychological profile were evaluated before and after the 6-month study. Biochemical and anthropometric indicators of nutritional status were not adversely affected by the therapy. Seventy-five percent of the children were able to remain free of soiling and the remaining 4 of 16 had soiling episodes reduced to a frequency of less than once a week. This study confirms that children with encopresis can respond to a combined program of increased fiber intake, laxatives, and mineral oil following a complete bowel cleanout, without experiencing deleterious effects.Pediatrics 04/1993; 91(3):591-4. · 5.30 Impact Factor