RESUMO
BACKGROUND: Constipation is one of the most common causes of consultation in pediatric practice, it has a multifactorial etiology and its treatment can be complex. OBJECTIVES AND METHODS: To establish the clinical guidelines for diagnosis and treatment of chronic constipation in pediatric population in Mexico, a review of the epidemiological, diagnostic and therapeutic aspects was conducted by an expert group of pediatric gastroenterologist in our country. RESULTS: Constipation is a symptom that reflects the presence of fecal retention, which is reported by patients or their relatives as decreased stool frequency, hard stools, and sometimes pain and excessive pushing. Constipation can occur at any stage of childhood. The main trigger for fecal retention is the painful evacuation. Patients who meet the Rome III criteria for functional constipation do not require diagnostic tests. The diagnostic tests are reserved for cases in which alarm signs are present and in patients refractory to conventional treatment. The goal of treatment is to promote smooth and painless evacuations preventing reaccumulation of stool. Osmotic laxatives such as polyethylene glycol and lactulose are the most effective treatments. In special cases, biofeedback therapy, the use of botulinum toxin and surgery can be effective, although the evidence is weak. CONCLUSIONS: Management of chronic constipation in pediatric population requires a comprehensive diagnostic approach.
Assuntos
Constipação Intestinal/diagnóstico , Constipação Intestinal/terapia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Constipação Intestinal/tratamento farmacológico , Medicina Baseada em Evidências , Feminino , Humanos , Lactente , Recém-Nascido , Laxantes/uso terapêutico , Imageamento por Ressonância Magnética , Masculino , Manometria , MéxicoAssuntos
Infecções por Helicobacter/terapia , Helicobacter pylori , Lactobacillus , Adolescente , Criança , Pré-Escolar , Método Duplo-Cego , HumanosRESUMO
UNLABELLED: Gastroesophageal reflux (GER) is a common disease in children less one year old. It is present around 10% of unselected infant population. 40-50% have abnormal 24 h pH monitoring. An early diagnosis and treatment should be done in order to avoid complications. AIM: To establish the consensus for the diagnosis and treatment of children with GER, to rule out similar diseases avoid the use of unnecessary drugs and the secondary side effects as well as unnecessary surgery. METHOD: The consensus was done with the participation of general pediatricians, pediatrics gastroenterologist, pediatric surgeons, radiologist and endoscopist. An initial paper was done by pediatric surgeon and pediatric gastroenterologist who submitted to the rest of participants. Second stage: the paper was review through E-mail for all participants who send their suggestions and modifications. A new paper was done and discussed by medical and surgery area. During the Congress of Pediatric Surgery, in an open session was discuss again with the participation of the main authors and all the audience present. Finally, a paper was done and review for the main authors.
