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
