Evaluation and management of pediatric refractory constipation: Recommendations from the NASPGHAN neurogastroenterology and motility committee

Alexandra L Kilgore; Mary K Rogers Boruta; Lusine Ambartsumyan; Roberto Gomez Suarez; Dhiren Patel; Richard J Wood; Anil Darbari; Leonel Rodriguez

doi:10.1002/jpn3.12390

Evaluation and management of pediatric refractory constipation: Recommendations from the NASPGHAN neurogastroenterology and motility committee

J Pediatr Gastroenterol Nutr. 2024 Dec 31. doi: 10.1002/jpn3.12390. Online ahead of print.

Authors

Alexandra L Kilgore^{1

2}, Mary K Rogers Boruta³, Lusine Ambartsumyan⁴, Roberto Gomez Suarez⁵, Dhiren Patel⁶, Richard J Wood⁷, Anil Darbari⁸, Leonel Rodriguez⁹

Affiliations

¹ Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado, USA.
² Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA.
³ Levine Children's Hospital, Atrium Health, Charlotte, North Carolina, USA.
⁴ Division of Gastroenterology and Hepatology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA.
⁵ Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nemours Children's Hospital, Orlando, Florida, USA.
⁶ Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cardinal Glennon Children's Medical Center, Saint Louis University School of Medicine, St Louis, Missouri, USA.
⁷ Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA.
⁸ Pediatric Gastroenterology, Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
⁹ Section of Pediatric Gastroenterology, Hepatology and Nutrition, Yale University School of Medicine, New Haven, Connecticut, USA.

PMID: 39741384
DOI: 10.1002/jpn3.12390

Abstract

Refractory constipation (RC) in pediatric patients should be recognized as a distinct condition with long-term impacts on patient and family quality of life. RC requires a more targeted diagnostic evaluation and complex management strategy that may involve management by pediatric neurogastroenterology and motility specialists and multidisciplinary teams including surgeons. Currently, there is a lack of a clear definition, evaluation, and management strategies for RC. This is the first North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition position paper to address pediatric RC regarding its definition, evaluation, and management.

Keywords: constipation evaluation; constipation management; motility studies for constipation; surgical interventions for constipation.