{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:01:01Z","timestamp":1791489661948,"version":"4.3.4"},"reference-count":130,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Functional constipation (FC) affects up to 32% of the pediatric population, and some of these patients are referred to pediatric surgery units to manage their constipation and\/or fecal incontinence. The aim of the current paper is to report the recent updates on the evaluation and management of children with FC as a part of a manuscript series on bowel management in patients with anorectal malformations, Hirschsprung disease, spinal anomalies, and FC. Methods: A literature search was performed using Medline\/PubMed, Google Scholar, Cochrane, and EMBASE databases and focusing on the manuscripts published within the last 5\u201310 years. Results: The first step of management of children with FC is to exclude Hirschsprung disease with a contrast study, examination under anesthesia, anorectal manometry (AMAN). If AMAN shows absent rectoanal inhibitory reflex, a rectal biopsy is performed. Internal sphincter achalasia or high resting pressures indicate botulinum toxin injection. Medical management options include laxatives, rectal enemas, transanal irrigations, and antegrade flushes. Those who fail conservative treatment require further assessment of colonic motility and can be candidates for colonic resection. The type of resection (subtotal colonic resection vs. Deloyer\u2019s procedure) can be guided with a balloon expulsion test. Conclusion: Most of the patients with FC referred for surgical evaluation can be managed conservatively. Further studies are required to determine an optimal strategy of surgical resection in children unresponsive to medical treatment.<\/jats:p>","DOI":"10.3390\/children10061078","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T01:37:38Z","timestamp":1687225058000},"page":"1078","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["State of the Art Bowel Management for Pediatric Colorectal Problems: Functional Constipation"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0712-3508","authenticated-orcid":false,"given":"Elizaveta","family":"Bokova","sequence":"first","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy Jo","family":"Svetanoff","sequence":"additional","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Children\u2019s Mercy Kansas City, Kansas City, MO 64108, USA"},{"name":"Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Levitt","sequence":"additional","affiliation":[{"name":"Division of Colorectal and Pelvic Reconstruction, Children\u2019s National Medical Center, Washington, DC 20001, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8689-5989","authenticated-orcid":false,"given":"Rebecca M.","family":"Rentea","sequence":"additional","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"},{"name":"Department of Surgery, University of Missouri-Kansas City, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.jpeds.2018.02.029","article-title":"Prevalence of Functional Defecation Disorders in Children: A Systematic Review and Meta-Analysis","volume":"198","author":"Koppen","year":"2018","journal-title":"J. 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