{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T21:25:29Z","timestamp":1791408329751,"version":"4.3.3"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,3,31]],"date-time":"2015-03-31T00:00:00Z","timestamp":1427760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003035","name":"Aase og Ejnar Danielsens Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003035","id-type":"DOI","asserted-by":"publisher"}]},{"name":"A P Moeller and Wife Chastine Mc-Kinney Moellers Foundation"},{"name":"Danish Medical Association"},{"name":"Familien Hede Nielsens Fond"},{"name":"Hospital Lillebaelt"},{"name":"Jubilee Foundation of 12.08.1973"},{"name":"Region of Southern Denmark"},{"name":"University of Southern Denmark"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Most research on functional constipation has been carried out at a tertiary level. We focused this study on a secondary\u2010level hospital outpatients' department, assessing the distribution of diagnostic criteria for childhood functional constipation and evaluating the consequences of current diagnostic practice based on current guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 235 children, aged two to 16\u00a0years of age, with functional constipation according to the Rome <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> criteria and assessed them using medical histories and physical examinations, including rectal examinations and ultrasound measurements of rectal diameter. Faecal impaction was a rectal diameter exceeding 3\u00a0cm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The most frequently reported symptom was painful bowel movements (72.3%) and 39.1% had faecal incontinence. Rectal examination identified faecal impaction in 149 children (66.2%), and ultrasound showed a mean rectal diameter of 3.4\u00a0\u00b1\u00a00.6\u00a0cm, compared to 2.2\u00a0\u00b1\u00a00.6\u00a0cm in children without impaction (p\u00a0&lt;\u00a00.001). Of the 149 children with faecal impaction, 19 (12.8%) only had one additional Rome <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> criterion. The rectal diameter exceeded 3\u00a0cm in 79.9% of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Identifying faecal impaction is important for ensuring the timely diagnosis of childhood functional constipation at the secondary care level. Ultrasound examination proved a reliable alternative to rectal examination or abdominal radiography when identifying faecal impaction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.12991","type":"journal-article","created":{"date-parts":[[2015,3,2]],"date-time":"2015-03-02T19:26:16Z","timestamp":1425324376000},"page":"838-842","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Identifying faecal impaction is important for ensuring the timely diagnosis of childhood functional constipation"],"prefix":"10.1111","volume":"104","author":[{"given":"Line","family":"Modin","sequence":"first","affiliation":[{"name":"Department of Paediatrics Hospital Lillebaelt Kolding Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Mette","family":"Walsted","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Hospital Lillebaelt Kolding 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