{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:42:37Z","timestamp":1790620957151,"version":"4.1.0"},"reference-count":160,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Traditional Chinese Medicine Science and Technology Plan of Zhejiang Province","award":["2025ZL150"],"award-info":[{"award-number":["2025ZL150"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:p>\n                    Pediatric functional constipation (PFC) is a prevalent gastrointestinal disorder affecting approximately 18.2% of children worldwide, characterized by infrequent or painful bowel movements without organic cause, and significantly impairing quality of life, yet its management remains suboptimal. A central problem in its management is the high failure rate of conventional therapies; notably, treatments such as laxatives fail to achieve sustained relief in about 40% of pediatric patients, highlighting the critical need to explore novel pathophysiological mechanisms and therapeutic targets. Emerging evidence now highlights gut microbiota dysbiosis and the resulting imbalances in intestinal gases\u2014particularly hydrogen (H\u2082), methane (CH\u2084), carbon dioxide (CO\u2082), and hydrogen sulfide (H\u2082S)\u2014as key drivers of its pathophysiology. This review synthesizes current knowledge on how microbial gas metabolism influences gut motility in PFC: elevated CH\u2084, produced by methanogenic archaea such as\n                    <jats:italic>Methanobrevibacter smithii<\/jats:italic>\n                    , strongly correlates with delayed colonic transit and symptom severity, while H\u2082 enhances motility, and CO\u2082 and H\u2082S exert dose-dependent effects on peristalsis and mucosal signaling. Recent diagnostic advances, including H\u2082\/CH\u2084 breath testing, electronic nose (E-nose) volatile organic compound profiling, and wireless motility capsules, enable non-invasive assessment of gas dynamics and transit, supporting precision phenotyping. Therapeutic strategies targeting gas-microbiota interactions\u2014such as methane-lowering antibiotics (e.g., rifaximin), probiotics (e.g.,\n                    <jats:italic>Lactobacillus plantarum<\/jats:italic>\n                    ), low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diets, and neuromodulation\u2014show promise, but pediatric-specific thresholds, safety, and long-term outcomes remain underexplored. The principal novelty of this review lies in its integrative framework, combining gastroenterology, microbiology, and engineering perspectives to advance gas-targeted precision medicine in PFC. Finally, we identify critical research gaps \u2014such as the lack of pediatric-specific diagnostic thresholds and long-term therapeutic validation\u2014and emphasize the urgent need for longitudinal studies and multidisciplinary trials to translate these insights into meaningful clinical outcomes.\n                  <\/jats:p>","DOI":"10.3389\/fnut.2025.1694831","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T06:28:49Z","timestamp":1767335329000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The role of intestinal gases in pediatric functional constipation: a narrative review of pathophysiology and emerging therapeutics"],"prefix":"10.3389","volume":"12","author":[{"given":"Yuewen","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enfu","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"123","DOI":"10.5056\/jnm18035","article-title":"Functional chronic constipation: Rome III criteria versus Rome IV criteria","volume":"25","author":"Russo","year":"2019","journal-title":"J Neurogastroenterol Motil"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1007\/s12098-024-05387-5","article-title":"Functional constipation in children","volume":"92","author":"Satya","year":"2025","journal-title":"Indian J 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