Nonpharmacologic treatments for childhood constipation: systematic review
Open accessAbstract
OBJECTIVE: To summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine. METHODS: We systematically searched 3 major electronic databases and reference lists of existing reviews. We included systematic reviews and randomized controlled trials (RCTs) that reported on nonpharmacologic treatments. Two reviewers rated the methodologic quality independently. RESULTS: We included 9 studies with 640 children. Considerable heterogeneity across studies precluded meta-analysis. We found no RCTs for physical movement, multidisciplinary treatment, or alternative medicine. Some evidence shows that fiber may be more effective than placebo in improving both the frequency and consistency of stools and in reducing abdominal pain. Compared with normal fluid intake, we found no evidence that water intake increases or that hyperosmolar fluid treatment is more effective in increasing stool frequency or decreasing difficulty in passing stools. We found no evidence to recommend the use of prebiotics or probiotics. Behavioral therapy with laxatives is not more effective than laxatives alone. CONCLUSIONS: There is some evidence that fiber supplements are more effective than placebo. No evidence for any effect was found for fluid supplements, prebiotics, probiotics, or behavioral intervention. There is a lack of well-designed RCTs of high quality concerning nonpharmacologic treatments for children with functional constipation.
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Current evidence is weak for using fiber to treat functional constipation in children.
“there is currently little evidence to support the use of fiber for pediatric FC. Multiple systematic reviews note the sparse data and high risk of bias among the current evidence base169–172.”
From The gut Microbiome in adult and pediatric functional gastrointestinal disorders (2019) · cites this paper as [170]
Several systematic reviews describe limited data and high bias risk in studies of fiber for pediatric functional constipation.
“Multiple systematic reviews note the sparse data and high risk of bias among the current evidence base169–172.”
From The gut Microbiome in adult and pediatric functional gastrointestinal disorders (2019) · cites this paper as [170]
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BackgroundThe gut Microbiome in adult and pediatric functional gastrointestinal disorders
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- Authors
- Tabbers, M. M., Boluyt, N., Berger, M. Y., & Benninga, M. A.
- Affiliations
- Departments of Pediatric Gastroenterology and Nutrition and
- Amsterdam UMC Location University of Amsterdam (NL)
- University Medical Center Groningen (NL)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2011-10-01
- Volume
- 128
- Issue
- 4
- Pages
- 753-761
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2153804076
- Cited by
- 95
- References
- 27
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 9 · 2020: 4 · 2019: 3 · 2018: 10 · 2017: 4 · 2016: 7 · 2015: 11 · 2014: 13 · 2013: 11 · 2012: 7
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- PEDIATRICS (publishedVersion, other-oa)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Intestinal Malrotation and Obstruction Disorders
- Keywords
- pediatric constipation, functional constipation, non-pharmacological treatment, dietary fiber, fluid intake, prebiotics, probiotics, behavior therapy, laxatives, abdominal pain, stool frequency, multidisciplinary treatment, complementary and alternative medicine
- MeSH terms
- Complementary Therapies, Behavior Therapy, Child, Constipation, Dietary Fiber, Fluid Therapy, Humans, Motor Activity, Dietary Supplements, Probiotics, Laxatives, Prebiotics
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