{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T20:15:52Z","timestamp":1784060152194,"version":"3.55.0"},"reference-count":85,"publisher":"Hogrefe Publishing Group","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zeitschrift f\u00fcr Kinder- und Jugendpsychiatrie und Psychotherapie"],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"<jats:p> Zusammenfassung. Hintergrund: Obstipation und Stuhlinkontinenz geh\u00f6ren zu den h\u00e4ufigsten St\u00f6rungen des Kindesalters, die mit einer hohen Beeintr\u00e4chtigung und komorbiden psychischen St\u00f6rungen einhergehen k\u00f6nnen. Nach der neuen Rome-IV-Klassifikation wird zwischen einer funktionellen Obstipation und einer nicht-retentiven Stuhlinkontinenz unterschieden. Das Ziel dieser interdisziplin\u00e4ren Leitlinie ist es, den aktuellen Stand zur Diagnostik und Therapie dieser St\u00f6rungen aus somatischer und psychiatrischer Sicht zusammenzufassen und praxisorientierte Empfehlungen zu formulieren. Methoden: Die Leitliniengruppe setzte sich aus 11 Fachgesellschaften und einer Elterngruppe zusammen. Die Leitlinie wurde auf der Basis aktueller Literaturrecherchen in mehreren Onlineabstimmungen und Konsensuskonferenzen nach den Regeln der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF) verabschiedet. Ergebnisse: Die funktionelle Obstipation ist sehr viel h\u00e4ufiger als die nicht-retentive Stuhlinkontinenz. Die Obstipation erfordert ein sorgf\u00e4ltiges medizinisches Vorgehen, um somatische Ursachen auszuschlie\u00dfen, gerade bei jungen Kindern. Dazu dienen somatische Warnzeichen, die besonders ber\u00fccksichtigt werden m\u00fcssen. Die meisten F\u00e4lle der Obstipation sind funktionell (ca. 95 %). Beratung, Toilettentraining, Desimpaktion und langfristige orale Laxanzien, kombiniert mit verhaltenstherapeutischen Ma\u00dfnahmen, sind am wirkungsvollsten. Die Diagnostik und Therapie der nicht-retentiven Stuhlinkontinenz ist \u00e4hnlich. Die Rate von somatischen Ursachen ist niedriger. Laxanzien k\u00f6nnen allerdings die Symptomatik verschlechtern und sollten vermieden werden. Komorbide psychische St\u00f6rungen sind h\u00e4ufig (ca. 30\u201350 % der F\u00e4lle). Sie sollen erfasst und zus\u00e4tzlich leitliniengerecht behandelt werden. Schlussfolgerungen: Im Konsensusverfahren konnten mit hoher Zustimmung wichtige Empfehlungen verabschiedet werden. Eine interdisziplin\u00e4re Zusammenarbeit ist von hoher Bedeutung, da somatische Faktoren und komorbide psychische St\u00f6rungen und Symptome ber\u00fccksichtigt werden m\u00fcssen. Forschungsbedarf besteht vor allem bei der nicht-retentiven Stuhlinkontinenz. <\/jats:p>","DOI":"10.1024\/1422-4917\/a000920","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T17:59:58Z","timestamp":1674151198000},"page":"233-250","source":"Crossref","is-referenced-by-count":4,"title":["Funktionelle (nicht-organische) Obstipation und Stuhlinkontinenz im                     Kindes- und Jugendalter: Klinische Leitlinie zur Diagnostik und                     Therapie"],"prefix":"10.1024","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3579-6200","authenticated-orcid":true,"given":"Alexander","family":"von Gontard","sequence":"first","affiliation":[{"name":"Psychiatrische Dienste Graub\u00fcnden,                     Ambulante Dienste f\u00fcr Kinder- und Jugendpsychiatrie, Chur,                         Schweiz"},{"name":"Governor Kremers Centre, Department of                     Urology, Maastricht University Medical Centre, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Cla\u00dfen","sequence":"additional","affiliation":[{"name":"P\u00e4diatrisch-gastroenterologische                     Praxis, Bremen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"101","reference":[{"key":"c1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-018-3697-4"},{"key":"c2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-320310"},{"key":"c3","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"c4","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2020.595531"},{"key":"c5","first-page":"179","volume":"121","author":"Bakwin H.","year":"1971","journal-title":"American Journal of Diseases of Childhood"},{"key":"c6","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0022"},{"key":"c7","doi-asserted-by":"publisher","DOI":"10.1136\/adc.71.3.186"},{"key":"c8","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.016"},{"key":"c9","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-200411000-00002"},{"key":"c10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jped.2017.01.005"},{"key":"c11","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000252187.12793.0a"},{"key":"c12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.11.029"},{"key":"c13","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002795"},{"key":"c14","doi-asserted-by":"publisher","DOI":"10.1111\/apa.12158"},{"key":"c15","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.16.3.213"},{"key":"c16","volume":"12","author":"Brazzelli M.","year":"2011","journal-title":"Cochrane Database Systematic Reviews"},{"key":"c17","doi-asserted-by":"publisher","DOI":"10.1007\/BF02895121"},{"key":"c18","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2013.01.001"},{"key":"c19","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2007.128769"},{"key":"c20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2017.12.003"},{"key":"c21","first-page":"679","volume":"119","author":"Cla\u00dfen M.","year":"2022","journal-title":"Deutsches \u00c4rzteblatt International"},{"key":"c22","unstructured":"Cla\u00dfen,\n                                M. &                                 von Gontard,\n                                A.                         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