Current Treatment Options for Children with Functional Constipation—What Is in the Pipeline?
In this review, we summarize current insights into the treatment of functional constipation (FC) in children. Constipation is a global issue in the pediatric population, with a prevalence of approximately 9.5%. Initial management involves a combination of non-pharmacological and pharmacological inte...
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MDPI AG
2025-06-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/12/7/857 |
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| author | Charlotte A. L. Jonker Tirza M. van Os Ramon R. Gorter Marc A. Levitt Marc A. Benninga |
| author_facet | Charlotte A. L. Jonker Tirza M. van Os Ramon R. Gorter Marc A. Levitt Marc A. Benninga |
| author_sort | Charlotte A. L. Jonker |
| collection | DOAJ |
| description | In this review, we summarize current insights into the treatment of functional constipation (FC) in children. Constipation is a global issue in the pediatric population, with a prevalence of approximately 9.5%. Initial management involves a combination of non-pharmacological and pharmacological interventions. However, a significant number of children continue to experience therapy-resistant FC despite optimal non-pharmacological and pharmacological treatments. While studies on novel pharmacological options in children are limited, adult trials have shown promising results. New agents such as lubiprostone, prucalopride, linaclotide, and plecanatide have demonstrated improved outcomes compared to placebo or conventional therapies, particularly in increasing spontaneous bowel movements. Neurostimulation presents an additional treatment modality. Posterior tibial nerve stimulation appears to be a promising new option, offering high treatment satisfaction and a favorable safety profile with a low rate of severe adverse events. For children who do not respond to optimal conservative therapy, the impact on quality of life can be substantial. In such cases, surgical interventions may be considered, including intrasphincteric botulinum toxin injections, antegrade continence enema surgery, and, in severe cases, colonic resection or a diverting ostomy. The choice of surgical treatment remains a subject of ongoing debate. Therapy-resistant FC in children is a complex and impactful condition. An individualized, stepwise approach is essential, with surgical options such as colonic resection reserved as a last resort. |
| format | Article |
| id | doaj-art-8d56510436ca4e4589f3b6a2da39baad |
| institution | DOAJ |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
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| series | Children |
| spelling | doaj-art-8d56510436ca4e4589f3b6a2da39baad2025-08-20T02:45:38ZengMDPI AGChildren2227-90672025-06-0112785710.3390/children12070857Current Treatment Options for Children with Functional Constipation—What Is in the Pipeline?Charlotte A. L. Jonker0Tirza M. van Os1Ramon R. Gorter2Marc A. Levitt3Marc A. Benninga4Department of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDepartment of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDepartment of Pediatric Surgery, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDivision of Colorectal and Pelvic Reconstruction, Children’s National Hospital, Washington, DC 20010, USADepartment of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsIn this review, we summarize current insights into the treatment of functional constipation (FC) in children. Constipation is a global issue in the pediatric population, with a prevalence of approximately 9.5%. Initial management involves a combination of non-pharmacological and pharmacological interventions. However, a significant number of children continue to experience therapy-resistant FC despite optimal non-pharmacological and pharmacological treatments. While studies on novel pharmacological options in children are limited, adult trials have shown promising results. New agents such as lubiprostone, prucalopride, linaclotide, and plecanatide have demonstrated improved outcomes compared to placebo or conventional therapies, particularly in increasing spontaneous bowel movements. Neurostimulation presents an additional treatment modality. Posterior tibial nerve stimulation appears to be a promising new option, offering high treatment satisfaction and a favorable safety profile with a low rate of severe adverse events. For children who do not respond to optimal conservative therapy, the impact on quality of life can be substantial. In such cases, surgical interventions may be considered, including intrasphincteric botulinum toxin injections, antegrade continence enema surgery, and, in severe cases, colonic resection or a diverting ostomy. The choice of surgical treatment remains a subject of ongoing debate. Therapy-resistant FC in children is a complex and impactful condition. An individualized, stepwise approach is essential, with surgical options such as colonic resection reserved as a last resort.https://www.mdpi.com/2227-9067/12/7/857functional constipationpediatricssurgerynew pharmacological approachesneurostimulation |
| spellingShingle | Charlotte A. L. Jonker Tirza M. van Os Ramon R. Gorter Marc A. Levitt Marc A. Benninga Current Treatment Options for Children with Functional Constipation—What Is in the Pipeline? Children functional constipation pediatrics surgery new pharmacological approaches neurostimulation |
| title | Current Treatment Options for Children with Functional Constipation—What Is in the Pipeline? |
| title_full | Current Treatment Options for Children with Functional Constipation—What Is in the Pipeline? |
| title_fullStr | Current Treatment Options for Children with Functional Constipation—What Is in the Pipeline? |
| title_full_unstemmed | Current Treatment Options for Children with Functional Constipation—What Is in the Pipeline? |
| title_short | Current Treatment Options for Children with Functional Constipation—What Is in the Pipeline? |
| title_sort | current treatment options for children with functional constipation what is in the pipeline |
| topic | functional constipation pediatrics surgery new pharmacological approaches neurostimulation |
| url | https://www.mdpi.com/2227-9067/12/7/857 |
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