Download PDF
Clin Colon Rectal Surg 2018; 31(02): 089-098
DOI: 10.1055/s-0037-1609023
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Surgical Management of Idiopathic Constipation in Pediatric Patients

Lily S. Cheng
1   Department of General Surgery, University of California San Francisco, San Francisco, California
,
Allan M. Goldstein
2   Department of Surgery, Harvard Medical School, Boston, Massachusetts
3   Department of Pediatric Surgery, Massachusetts General Hospital, Boston, Massachusetts
4   MassGeneral Hospital for Children, Boston, Massachusetts
› Author Affiliations
Further Information

Publication History

Publication Date:
25 February 2018 (online)

    Permissions and Reprints

Abstract

Constipation is a common childhood problem, but an anatomic or physiologic cause is identified in fewer than 5% of children. By definition, idiopathic constipation is a diagnosis of exclusion. Careful clinical evaluation and thoughtful use of imaging and other testing can help exclude specific causes of constipation and guide therapy. Medical management with laxatives is effective for the majority of constipated children. For those patients unresponsive to medications, however, several surgical options can be employed, including anal procedures, antegrade colonic enemas, colorectal resection, and intestinal diversion. Judicious use of these procedures in properly selected patients and based on appropriate preoperative testing can lead to excellent outcomes. This review summarizes the surgical options available for managing refractory constipation in children and provides guidance on how to choose the best procedure for a given patient.

Keywords

constipation - functional constipation - idiopathic constipation - antegrade colonic enemas - colorectal resection
 

  • References

  • 1 Walia R, Mulhearn N, Khan R, Cuffari C. Chronic constipation in children: an overview. Pract Gastroenterol 2013; 37 (07) 19-34
    PubMedGoogle Scholar
  • 2 Di Lorenzo C. Pediatric anorectal disorders. Gastroenterol Clin North Am 2001; 30 (01) 269-287 , ix
    CrossrefPubMedGoogle Scholar
  • 3 Liem O, Harman J, Benninga M, Kelleher K, Mousa H, Di Lorenzo C. Health utilization and cost impact of childhood constipation in the United States. J Pediatr 2009; 154 (02) 258-262
    CrossrefPubMedGoogle Scholar
  • 4 Di Lorenzo C, Benninga MA. Pathophysiology of pediatric fecal incontinence. Gastroenterology 2004; 126 (01) (Suppl. 01) S33-S40
    CrossrefPubMedGoogle Scholar
  • 5 Clark DA. Times of first void and first stool in 500 newborns. Pediatrics 1977; 60 (04) 457-459
    CrossrefPubMedGoogle Scholar
  • 6 Rasquin A, Di Lorenzo C, Forbes D. , et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 2006; 130 (05) 1527-1537
    CrossrefPubMedGoogle Scholar
  • 7 Hyman PE, Milla PJ, Benninga MA, Davidson GP, Fleisher DF, Taminiau J. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology 2006; 130 (05) 1519-1526
    CrossrefPubMedGoogle Scholar
  • 8 Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology 2006; 130 (05) 1480-1491
    CrossrefPubMedGoogle Scholar
  • 9 Tabbers MM, DiLorenzo C, Berger MY. , et al; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; North American Society for Pediatric Gastroenterology. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr 2014; 58 (02) 258-274
    CrossrefPubMedGoogle Scholar
  • 10 Noviello C, Cobellis G, Papparella A, Amici G, Martino A. Role of anorectal manometry in children with severe constipation. Colorectal Dis 2009; 11 (05) 480-484
    CrossrefPubMedGoogle Scholar
  • 11 Irani K, Rodriguez L, Doody DP, Goldstein AM. Botulinum toxin for the treatment of chronic constipation in children with internal anal sphincter dysfunction. Pediatr Surg Int 2008; 24 (07) 779-783
    CrossrefPubMedGoogle Scholar
  • 12 Belkind-Gerson J, Surjanhata B, Kuo B, Goldstein AM. Bear-down maneuver is a useful adjunct in the evaluation of children with chronic constipation. J Pediatr Gastroenterol Nutr 2013; 57 (06) 775-779
    CrossrefPubMedGoogle Scholar
  • 13 Lee YY, Erdogan A, Rao SS. High resolution and high definition anorectal manometry and pressure topography: diagnostic advance or a new kid on the block?. Curr Gastroenterol Rep 2013; 15 (12) 360
    CrossrefPubMedGoogle Scholar
  • 14 Pensabene L, Youssef NN, Griffiths JM, Di Lorenzo C. Colonic manometry in children with defecatory disorders. role in diagnosis and management. Am J Gastroenterol 2003; 98 (05) 1052-1057
    PubMedGoogle Scholar
  • 15 Villarreal J, Sood M, Zangen T. , et al. Colonic diversion for intractable constipation in children: colonic manometry helps guide clinical decisions. J Pediatr Gastroenterol Nutr 2001; 33 (05) 588-591
    CrossrefPubMedGoogle Scholar
  • 16 Martin MJ, Steele SR, Mullenix PS, Noel JM, Weichmann D, Azarow KS. A pilot study using total colonic manometry in the surgical evaluation of pediatric functional colonic obstruction. J Pediatr Surg 2004; 39 (03) 352-359 , discussion 352–359
    CrossrefPubMedGoogle Scholar
  • 17 Aspirot A, Fernandez S, Di Lorenzo C, Skaggs B, Mousa H. Antegrade enemas for defecation disorders: do they improve the colonic motility?. J Pediatr Surg 2009; 44 (08) 1575-1580
    CrossrefPubMedGoogle Scholar
  • 18 Christison-Lagay ER, Rodriguez L, Kurtz M, St Pierre K, Doody DP, Goldstein AM. Antegrade colonic enemas and intestinal diversion are highly effective in the management of children with intractable constipation. J Pediatr Surg 2010; 45 (01) 213-219 , discussion 219
    CrossrefPubMedGoogle Scholar
  • 19 Sutcliffe JR, King SK, Hutson JM, Cook DJ, Southwell BR. Gastrointestinal transit in children with chronic idiopathic constipation. Pediatr Surg Int 2009; 25 (06) 465-472
    CrossrefPubMedGoogle Scholar
  • 20 Benninga MA, Büller HA, Tytgat GN, Akkermans LM, Bossuyt PM, Taminiau JA. Colonic transit time in constipated children: does pediatric slow-transit constipation exist?. J Pediatr Gastroenterol Nutr 1996; 23 (03) 241-251
    CrossrefPubMedGoogle Scholar
  • 21 Reuchlin-Vroklage LM, Bierma-Zeinstra S, Benninga MA, Berger MY. Diagnostic value of abdominal radiography in constipated children: a systematic review. Arch Pediatr Adolesc Med 2005; 159 (07) 671-678
    CrossrefPubMedGoogle Scholar
  • 22 Rosen R, Buonomo C, Andrade R, Nurko S. Incidence of spinal cord lesions in patients with intractable constipation. J Pediatr 2004; 145 (03) 409-411
    CrossrefPubMedGoogle Scholar
  • 23 Russell KW, Barnhart DC, Zobell S, Scaife ER, Rollins MD. Effectiveness of an organized bowel management program in the management of severe chronic constipation in children. J Pediatr Surg 2015; 50 (03) 444-447
    CrossrefPubMedGoogle Scholar
  • 24 Gordon M, Naidoo K, Akobeng AK, Thomas AG. Cochrane review: osmotic and stimulant laxatives for the management of childhood constipation. (Review) Evid Based Child Health 2013; 8 (01) 57-109
    CrossrefPubMedGoogle Scholar
  • 25 van der Plas RN, Benninga MA, Büller HA. , et al. Biofeedback training in treatment of childhood constipation: a randomised controlled study. Lancet 1996; 348 (9030): 776-780
    CrossrefPubMedGoogle Scholar
  • 26 Woodward S, Norton C, Chiarelli P. Biofeedback for treatment of chronic idiopathic constipation in adults. Cochrane Database Syst Rev 2014; 3 (03) CD008486
    PubMedGoogle Scholar
  • 27 Rao SS, Benninga MA, Bharucha AE, Chiarioni G, Di Lorenzo C, Whitehead WE. ANMS-ESNM position paper and consensus guidelines on biofeedback therapy for anorectal disorders. Neurogastroenterol Motil 2015; 27 (05) 594-609
    CrossrefPubMedGoogle Scholar
  • 28 van Engelenburg-van Lonkhuyzen ML, Bols EM, Benninga MA, Verwijs WA, Bluijssen NM, de Bie RA. The effect of pelvic physiotherapy on reduction of functional constipation in children: design of a multicentre randomised controlled trial. BMC Pediatr 2013; 13: 112
    CrossrefPubMedGoogle Scholar
  • 29 Thomas GP, Dudding TC, Rahbour G, Nicholls RJ, Vaizey CJ. Sacral nerve stimulation for constipation. Br J Surg 2013; 100 (02) 174-181
    CrossrefPubMedGoogle Scholar
  • 30 van Wunnik BP, Baeten CG, Southwell BR. Neuromodulation for constipation: sacral and transcutaneous stimulation. Best Pract Res Clin Gastroenterol 2011; 25 (01) 181-191
    PubMedGoogle Scholar
  • 31 Thaha MA, Abukar AA, Thin NN, Ramsanahie A, Knowles CH. Sacral nerve stimulation for faecal incontinence and constipation in adults. Cochrane Database Syst Rev 2015; 8 (08) CD004464
    PubMedGoogle Scholar
  • 32 van Wunnik BP, Peeters B, Govaert B, Nieman FH, Benninga MA, Baeten CG. Sacral neuromodulation therapy: a promising treatment for adolescents with refractory functional constipation. Dis Colon Rectum 2012; 55 (03) 278-285
    CrossrefPubMedGoogle Scholar
  • 33 Ismail KA, Chase J, Gibb S. , et al. Daily transabdominal electrical stimulation at home increased defecation in children with slow-transit constipation: a pilot study. J Pediatr Surg 2009; 44 (12) 2388-2392
    CrossrefPubMedGoogle Scholar
  • 34 Clarke MC, Chase JW, Gibb S, Hutson JM, Southwell BR. Improvement of quality of life in children with slow transit constipation after treatment with transcutaneous electrical stimulation. J Pediatr Surg 2009; 44 (06) 1268-1272 , discussion 1272
    CrossrefPubMedGoogle Scholar
  • 35 Clarke MC, Chase JW, Gibb S. , et al. Decreased colonic transit time after transcutaneous interferential electrical stimulation in children with slow transit constipation. J Pediatr Surg 2009; 44 (02) 408-412
    CrossrefPubMedGoogle Scholar
  • 36 Leong LC, Yik YI, Catto-Smith AG, Robertson VJ, Hutson JM, Southwell BR. Long-term effects of transabdominal electrical stimulation in treating children with slow-transit constipation. J Pediatr Surg 2011; 46 (12) 2309-2312
    CrossrefPubMedGoogle Scholar
  • 37 Sugarman I. Treatment of severe childhood constipation with restorative proctocolectomy: the surgeon's view. Arch Dis Child 2010; 95 (11) 861-862
    CrossrefPubMedGoogle Scholar
  • 38 Siminas S, Losty PD. Current surgical management of pediatric idiopathic constipation: a systematic review of published studies. Ann Surg 2015; 262 (06) 925-933
    CrossrefPubMedGoogle Scholar
  • 39 Kuizenga-Wessel S, Mousa HM, Benninga MA, Di Lorenzo C. Lack of agreement on how to use antegrade enemas in children. J Pediatr Gastroenterol Nutr 2016; 62 (01) 71-79
    CrossrefPubMedGoogle Scholar
  • 40 Wood RJ, Yacob D, Levitt MA. Surgical options for the management of severe functional constipation in children. Curr Opin Pediatr 2016; 28 (03) 370-379
    CrossrefPubMedGoogle Scholar
  • 41 Levitt MA, Mathis KL, Pemberton JH. Surgical treatment for constipation in children and adults. Best Pract Res Clin Gastroenterol 2011; 25 (01) 167-179
    CrossrefPubMedGoogle Scholar
  • 42 Keshtgar AS, Ward HC, Clayden GS. Pathophysiology of chronic childhood constipation: functional and morphological evaluation by anorectal manometry and endosonography and colonic transit study. J Pediatr Surg 2013; 48 (04) 806-812
    CrossrefPubMedGoogle Scholar
  • 43 Keshtgar AS, Ward HC, Clayden GS, Sanei A. Thickening of the internal anal sphincter in idiopathic constipation in children. Pediatr Surg Int 2004; 20 (11-12): 817-823
    CrossrefPubMedGoogle Scholar
  • 44 Hosie GP, Spitz L. Idiopathic constipation in childhood is associated with thickening of the internal anal sphincter. J Pediatr Surg 1997; 32 (07) 1041-1043 , discussion 1043–1044
    CrossrefPubMedGoogle Scholar
  • 45 Clayden GS, Lawson JO. Investigation and management of long-standing chronic constipation in childhood. Arch Dis Child 1976; 51 (12) 918-923
    CrossrefPubMedGoogle Scholar
  • 46 Keshtgar AS, Ward HC, Clayden GS, Sanei A. Role of anal dilatation in treatment of idiopathic constipation in children: long-term follow-up of a double-blind randomized controlled study. Pediatr Surg Int 2005; 21 (02) 100-105
    CrossrefPubMedGoogle Scholar
  • 47 De Caluwé D, Yoneda A, Akl U, Puri P. Internal anal sphincter achalasia: outcome after internal sphincter myectomy. J Pediatr Surg 2001; 36 (05) 736-738
    CrossrefPubMedGoogle Scholar
  • 48 Krebs C, Acuña R. Transanal internal sphincter myomectomy: indications, operative procedure and results. Eur J Pediatr Surg 1994; 4 (03) 151-157
    Article in Thieme ConnectPubMedGoogle Scholar
  • 49 Mishalany H. Seven years' experience with idiopathic unremitting chronic constipation. J Pediatr Surg 1989; 24 (04) 360-362
    CrossrefPubMedGoogle Scholar
  • 50 Langer JC, Birnbaum E. Preliminary experience with intrasphincteric botulinum toxin for persistent constipation after pull-through for Hirschsprung's disease. J Pediatr Surg 1997; 32 (07) 1059-1061 , discussion 1061–1062
    CrossrefPubMedGoogle Scholar
  • 51 Minkes RK, Langer JC. A prospective study of botulinum toxin for internal anal sphincter hypertonicity in children with Hirschsprung's disease. J Pediatr Surg 2000; 35 (12) 1733-1736
    CrossrefPubMedGoogle Scholar
  • 52 Ahmadi J, Azary S, Ashjaei B, Paragomi P, Khalifeh-Soltani A. Intrasphincteric botulinum toxin injection in treatment of chronic idiopathic constipation in children. Iran J Pediatr 2013; 23 (05) 574-578
    PubMedGoogle Scholar
  • 53 Keshtgar AS, Ward HC, Sanei A, Clayden GS. Botulinum toxin, a new treatment modality for chronic idiopathic constipation in children: long-term follow-up of a double-blind randomized trial. J Pediatr Surg 2007; 42 (04) 672-680
    CrossrefPubMedGoogle Scholar
  • 54 Chumpitazi BP, Fishman SJ, Nurko S. Long-term clinical outcome after botulinum toxin injection in children with nonrelaxing internal anal sphincter. Am J Gastroenterol 2009; 104 (04) 976-983
    CrossrefPubMedGoogle Scholar
  • 55 Keshtgar AS, Ward HC, Clayden GS. Diagnosis and management of children with intractable constipation. Semin Pediatr Surg 2004; 13 (04) 300-309
    CrossrefPubMedGoogle Scholar
  • 56 Keshtgar AS, Ward HC, Clayden GS. Transcutaneous needle-free injection of botulinum toxin: a novel treatment of childhood constipation and anal fissure. J Pediatr Surg 2009; 44 (09) 1791-1798
    CrossrefPubMedGoogle Scholar
  • 57 Malone PS, Ransley PG, Kiely EM. Preliminary report: the antegrade continence enema. Lancet 1990; 336 (8725): 1217-1218
    CrossrefPubMedGoogle Scholar
  • 58 Graf JL, Strear C, Bratton B. , et al. The antegrade continence enema procedure: a review of the literature. J Pediatr Surg 1998; 33 (08) 1294-1296
    CrossrefPubMedGoogle Scholar
  • 59 Levitt MA, Soffer SZ, Peña A. Continent appendicostomy in the bowel management of fecally incontinent children. J Pediatr Surg 1997; 32 (11) 1630-1633
    CrossrefPubMedGoogle Scholar
  • 60 Wilcox DT, Kiely EM. The Malone (antegrade colonic enema) procedure: early experience. J Pediatr Surg 1998; 33 (02) 204-206
    CrossrefPubMedGoogle Scholar
  • 61 Lynch AC, Beasley SW, Robertson RW, Morreau PN. Comparison of results of laparoscopic and open antegrade continence enema procedures. Pediatr Surg Int 1999; 15 (5-6): 343-346
    CrossrefPubMedGoogle Scholar
  • 62 Kiely EM, Ade-Ajayi N, Wheeler RA. Caecal flap conduit for antegrade continence enemas. Br J Surg 1994; 81 (08) 1215
    CrossrefPubMedGoogle Scholar
  • 63 Wong AL, Kravarusic D, Wong SL. Impact of cecostomy and antegrade colonic enemas on management of fecal incontinence and constipation: ten years of experience in pediatric population. J Pediatr Surg 2008; 43 (08) 1445-1451
    CrossrefPubMedGoogle Scholar
  • 64 Rivera MT, Kugathasan S, Berger W, Werlin SL. Percutaneous colonoscopic cecostomy for management of chronic constipation in children. Gastrointest Endosc 2001; 53 (02) 225-228
    CrossrefPubMedGoogle Scholar
  • 65 Shandling B, Chait PG, Richards HF. Percutaneous cecostomy: a new technique in the management of fecal incontinence. J Pediatr Surg 1996; 31 (04) 534-537
    CrossrefPubMedGoogle Scholar
  • 66 Sinha CK, Butler C, Haddad M. Left antegrade continent enema (LACE): review of the literature. Eur J Pediatr Surg 2008; 18 (04) 215-218
    Article in Thieme ConnectPubMedGoogle Scholar
  • 67 Chang HK, Chang EY, Han SJ, Choi SH, Oh JT. Long-term outcome of left- vs right-sided antegrade continence enema. J Pediatr Surg 2012; 47 (10) 1880-1885
    CrossrefPubMedGoogle Scholar
  • 68 Rodriguez L, Flores A, Gilchrist BF, Goldstein AM. Laparoscopic-assisted percutaneous endoscopic cecostomy in children with defecation disorders (with video). Gastrointest Endosc 2011; 73 (01) 98-102
    CrossrefPubMedGoogle Scholar
  • 69 Siddiqui AA, Fishman SJ, Bauer SB, Nurko S. Long-term follow-up of patients after antegrade continence enema procedure. J Pediatr Gastroenterol Nutr 2011; 52 (05) 574-580
    CrossrefPubMedGoogle Scholar
  • 70 Mugie SM, Machado RS, Mousa HM. , et al. Ten-year experience using antegrade enemas in children. J Pediatr 2012; 161 (04) 700-704
    CrossrefPubMedGoogle Scholar
  • 71 Mousa HM, van den Berg MM, Caniano DA, Hogan M, Di Lorenzo C, Hayes J. Cecostomy in children with defecation disorders. Dig Dis Sci 2006; 51 (01) 154-160
    CrossrefPubMedGoogle Scholar
  • 72 Cascio S, Flett ME, De la Hunt M, Barrett AM, Jaffray B. MACE or caecostomy button for idiopathic constipation in children: a comparison of complications and outcomes. Pediatr Surg Int 2004; 20 (07) 484-487
    CrossrefPubMedGoogle Scholar
  • 73 Hoekstra LT, Kuijper CF, Bakx R, Heij HA, Aronson DC, Benninga MA. The Malone antegrade continence enema procedure: the Amsterdam experience. J Pediatr Surg 2011; 46 (08) 1603-1608
    CrossrefPubMedGoogle Scholar
  • 74 King SK, Sutcliffe JR, Southwell BR, Chait PG, Hutson JM. The antegrade continence enema successfully treats idiopathic slow-transit constipation. J Pediatr Surg 2005; 40 (12) 1935-1940
    CrossrefPubMedGoogle Scholar
  • 75 Bonilla SF, Flores A, Jackson CC, Chwals WJ, Orkin BA. Management of pediatric patients with refractory constipation who fail cecostomy. J Pediatr Surg 2013; 48 (09) 1931-1935
    CrossrefPubMedGoogle Scholar
  • 76 Chan DS, Delicata RJ. Meta-analysis of antegrade continence enema in adults with faecal incontinence and constipation. Br J Surg 2016; 103 (04) 322-327
    CrossrefPubMedGoogle Scholar
  • 77 Peeraully MR, Lopes J, Wright A. , et al. Experience of the MACE procedure at a regional pediatric surgical unit: a 15-year retrospective review. Eur J Pediatr Surg 2014; 24 (01) 113-116
    Article in Thieme ConnectPubMedGoogle Scholar
  • 78 Curry JI, Osborne A, Malone PS. The MACE procedure: experience in the United Kingdom. J Pediatr Surg 1999; 34 (02) 338-340
    CrossrefPubMedGoogle Scholar
  • 79 Randall J, Coyne P, Jaffray B. Follow up of children undergoing antegrade continent enema: experience of over two hundred cases. J Pediatr Surg 2014; 49 (09) 1405-1408
    CrossrefPubMedGoogle Scholar
  • 80 Levitt MA, Martin CA, Falcone Jr RA, Peña A. Transanal rectosigmoid resection for severe intractable idiopathic constipation. J Pediatr Surg 2009; 44 (06) 1285-1290 , discussion 1290–1291
    CrossrefPubMedGoogle Scholar
  • 81 Lee SL, DuBois JJ, Montes-Garces RG, Inglis K, Biediger W. Surgical management of chronic unremitting constipation and fecal incontinence associated with megarectum: a preliminary report. J Pediatr Surg 2002; 37 (01) 76-79
    CrossrefPubMedGoogle Scholar
  • 82 Godbole PP, Pinfield A, Stringer MD. Idiopathic megarectum in children. Eur J Pediatr Surg 2001; 11 (01) 48-51
    Article in Thieme ConnectPubMedGoogle Scholar
  • 83 Kerur B, Kantekure K, Bonilla S, Orkin B, Flores AF. Management of chronic intractable constipation in children. J Pediatr Gastroenterol Nutr 2014; 59 (06) 754-757
    CrossrefPubMedGoogle Scholar
  • 84 Levitt MA, Peña A. Surgery and constipation: when, how, yes, or no?. J Pediatr Gastroenterol Nutr 2005; 41 (Suppl. 01) S58-S60
    CrossrefPubMedGoogle Scholar
  • 85 Stabile G, Kamm MA, Hawley PR, Lennard-Jones JE. Results of the Duhamel operation in the treatment of idiopathic megarectum and megacolon. Br J Surg 1991; 78 (06) 661-663
    CrossrefPubMedGoogle Scholar
  • 86 Gladman MA, Scott SM, Lunniss PJ, Williams NS. Systematic review of surgical options for idiopathic megarectum and megacolon. Ann Surg 2005; 241 (04) 562-574
    CrossrefPubMedGoogle Scholar
  • 87 Kamm MA, Stabile G. Management of idiopathic megarectum and megacolon. Br J Surg 1991; 78 (08) 899-900
    CrossrefPubMedGoogle Scholar
  • 88 Stabile G, Kamm MA, Hawley PR, Lennard-Jones JE. Colectomy for idiopathic megarectum and megacolon. Gut 1991; 32 (12) 1538-1540
    CrossrefPubMedGoogle Scholar
  • 89 Stabile G, Kamm MA. Surgery for idiopathic megarectum and megacolon. Int J Colorectal Dis 1991; 6 (03) 171-174
    CrossrefPubMedGoogle Scholar
  • 90 Youssef NN, Pensabene L, Barksdale Jr E, Di Lorenzo C. Is there a role for surgery beyond colonic aganglionosis and anorectal malformations in children with intractable constipation?. J Pediatr Surg 2004; 39 (01) 73-77
    CrossrefPubMedGoogle Scholar
  • 91 Asipu D, Jaffray B. Treatment of severe childhood constipation with restorative proctocolectomy. Arch Dis Child 2010; 95 (11) 867-870
    PubMedGoogle Scholar
  • 92 Hosie KB, Kmiot WA, Keighley MR. Constipation: another indication for restorative proctocolectomy. Br J Surg 1990; 77 (07) 801-802
    CrossrefPubMedGoogle Scholar
  • 93 Stewart J, Kumar D, Keighley MR. Results of anal or low rectal anastomosis and pouch construction for megarectum and megacolon. Br J Surg 1994; 81 (07) 1051-1053
    CrossrefPubMedGoogle Scholar
  • 94 Thakur A, Fonkalsrud EW, Buchmiller T, French S. Surgical treatment of severe colonic inertia with restorative proctocolectomy. Am Surg 2001; 67 (01) 36-40
    PubMedGoogle Scholar
  • 95 Woodward MN, Foley P, Cusick EL. Colostomy for treatment of functional constipation in children: a preliminary report. J Pediatr Gastroenterol Nutr 2004; 38 (01) 75-78
    CrossrefPubMedGoogle Scholar
  • 96 Park JJ, Del Pino A, Orsay CP. , et al. Stoma complications: the Cook County Hospital experience. Dis Colon Rectum 1999; 42 (12) 1575-1580
    CrossrefPubMedGoogle Scholar
  • 97 Stabile G, Kamm MA, Hawley PR, Lennard-Jones JE. Results of stoma formation for idiopathic megarectum and megacolon. Int J Colorectal Dis 1992; 7 (02) 82-84
    CrossrefPubMedGoogle Scholar
  • 98 Kuizenga-Wessel S, Benninga MA, Tabbers MM. Reporting outcome measures of functional constipation in children from 0 to 4 years of age. J Pediatr Gastroenterol Nutr 2015; 60 (04) 446-456
    CrossrefPubMedGoogle Scholar
  • 99 Kuizenga-Wessel S, Heckert SL, Tros W, van Etten-Jamaludin FS, Benninga MA, Tabbers MM. Reporting on outcome measures of functional constipation in children—a systematic review. J Pediatr Gastroenterol Nutr 2016; 62 (06) 840-846
    CrossrefPubMedGoogle Scholar
  • 100 van Ginkel R, Reitsma JB, Büller HA, van Wijk MP, Taminiau JA, Benninga MA. Childhood constipation: longitudinal follow-up beyond puberty. Gastroenterology 2003; 125 (02) 357-363
    CrossrefPubMedGoogle Scholar
  • 101 Pijpers MA, Bongers ME, Benninga MA, Berger MY. Functional constipation in children: a systematic review on prognosis and predictive factors. J Pediatr Gastroenterol Nutr 2010; 50 (03) 256-268
    CrossrefPubMedGoogle Scholar
  • 102 Bongers ME, van Wijk MP, Reitsma JB, Benninga MA. Long-term prognosis for childhood constipation: clinical outcomes in adulthood. Pediatrics 2010; 126 (01) e156-e162
    CrossrefPubMedGoogle Scholar
  • 103 Tran K, Staller K, Macklin E, Goldstein A, Belkind-Gerson J, Kuo B. Need for rectal biopsy for childhood constipation predicts severity of illness and need for laxatives. J Pediatr Gastroenterol Nutr 2016; 62 (06) 834-839
    CrossrefPubMedGoogle Scholar
  • 104 Jaffray B. What happens to children with idiopathic constipation who receive an antegrade continent enema? An actuarial analysis of 80 consecutive cases. J Pediatr Surg 2009; 44 (02) 404-407
    CrossrefPubMedGoogle Scholar
  • 105 Pensabene L, Youssef NN, Di Lorenzo C. [Success of antegrade enemas in children with functional constipation]. Pediatr Med Chir 2003; 25 (02) 126-130
    PubMedGoogle Scholar
  • 106 Youssef NN, Barksdale Jr E, Griffiths JM, Flores AF, Di Lorenzo C. Management of intractable constipation with antegrade enemas in neurologically intact children. J Pediatr Gastroenterol Nutr 2002; 34 (04) 402-405
    CrossrefPubMedGoogle Scholar
  • 107 Platell C, Scache D, Mumme G, Stitz R. A long-term follow-up of patients undergoing colectomy for chronic idiopathic constipation. Aust N Z J Surg 1996; 66 (08) 525-529
    CrossrefPubMedGoogle Scholar
  • 108 Hutson JM, Wheatley J, Uemura S, Hurley M. A long-term follow-up of patients undergoing colectomy for chronic idiopathic constipation. Aust N Z J Surg 1997; 67 (2-3): 136 , author reply 137
    CrossrefPubMedGoogle Scholar