Volume 29, Issue 163, September 2025

Functional constipation in children and adolescents - etiology, treatment and management in clinical practice

Aleksandra Wądołowska^1♦, Michał Wilk², Daniel Narożniak³, Karolina Kusek⁴, Katarzyna Ciepłucha⁵, Jan Wojdal⁶, Zuzanna Mogilany⁷, Barbara Przybył⁸, Mateusz Mierniczek⁹, Maria Wydra¹⁰

¹University Clinical Hospital No. 1 of the Medical University of Lodz, Kopcińskiego 22, 90-153 Łódź, Poland
²Central Clinical Hospital, of Medical University of Lodz; Pomorska 251, Łódź, Poland
³St. Raphael’s Voivodeship Specialist Hospital in Czerwona Góra, Czerwona Góra 10, 26-060 Chęciny, Poland
⁴Central Clinical Hospital of Medical University of Lodz; Pomorska 251, 92-213 Łódź, Poland
⁵Rydygier Specialist Hospital in Krakow, Osiedle Złotej Jesieni 1, 31- 820 Kraków, Poland
⁶Copernicus Memorial Hospital, Pabianicka 62, 93-513, Łódź, Poland
⁷Hospital of the Ministry of Interior and Administration in Lodz, Północna 42, 91–425 Łódź: Lodz, Poland
⁸University Clinical Hospital No. 2 of the Medical University of Lodz; Stefana Żeromskiego 113, 90-549 Łódź, Poland
⁹St. Raphael’s Voivodeship Specialist Hospital in Czerwona Góra, Czerwona Góra 10, 26-060 Chęciny, Poland
¹⁰Rydygier Specialist Hospital in Krakow; Osiedle Złotej Jesieni 1, 31- 820 Kraków, Poland

^♦Corresponding author
Aleksandra Wądołowska, University Clinical Hospital No. 1 of the Medical University of Lodz, Kopcińskiego 22, 90-153 Łódź, Poland

ABSTRACT

Background: Functional constipation (FC) is the most prevalent functional gastrointestinal disease in children, affecting approximately 14.4% of the pediatric population worldwide. While FC is not harmful itself, it can cause serious medical problems, such as fecal incontinence, dysfunction of the urinary tract, and psychological distress, which can occur when children receive delayed diagnosis and treatment. Objective: This review aims to summarize existing evidence on functional constipation in children, including its definition, diagnosis, prevalence, clinical presentation, and treatment. Methods: The review employed Rome IV diagnostic criteria, ESPGHAN/NASPGHAN guidelines, WHO guidelines, PubMed, and Google Scholar databases, along with academic literature published between 1991 and 2025. Results: The diagnosis of FC depends on a clinical evaluation that includes symptom assessment and ruling out physical causes. The development of FC results from painful defecation and inappropriate toilet training as well as poor dietary choices, psychosocial stressors, and reduced physical activity levels. The treatment of FC begins with disimpaction, followed by pharmacological maintenance and behavior modification, before considering biofeedback or surgery for selected patients. Conclusion: The complex nature of childhood constipation requires individualized treatment approaches, which should involve multiple disciplines. The early identification of constipation combined with extended treatment reduces complications, which leads to a better quality of life for patients and their families.

Keywords: functional constipation, pediatric gastroenterology, polyethylene glycol, stool withholding

Medical Science, 2025, 29, e188ms3719

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DOI: https://doi.org/10.54905/disssi.v29i163.e188ms3719

Published: 29 September 2025