Unraveling childhood constipation: Pathophysiology, diagnostics and treatment

Constipation represents a common worldwide problem in children. In > 90% of children presenting with constipation, no obvious organic cause is found and a diagnosis of functional constipation (FC) is made. Most common symptoms of FC include infrequent bowel movements, painful and hard stools, fecal incontinence and withholding behavior. Children with FC report impaired health-related quality of life in relation to physical complaints and long duration of symptoms. The underlying pathophysiology of childhood constipation is multi-factorial, remains poorly understood, which makes treatment of these patients challenging. Patients with severe, refractory constipation are often referred to specialized centers for further diagnostic testing. Therapy options are limited and are largely based on experience rather than evidence. Therefore, the focus of this thesis is to unravel the pathophysiology, to improve diagnostic strategies and to discover new treatment options for childhood constipation.