{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T19:50:13Z","timestamp":1774986613416,"version":"3.50.1"},"reference-count":0,"publisher":"Sociedad Argentina de Gastroenterologia","issue":"1","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ACTA"],"abstract":"<jats:p>El estre\u00f1imiento funcional refractario es un desaf\u00edo persistente en pediatr\u00eda. M\u00e1s all\u00e1 del polietilenglicol y los laxantes tradicionales, surgen nuevas terapias farmacol\u00f3gicas y no farmacol\u00f3gicas. Entre los medicamentos innovadores se destacan los agentes prosecretorios, como linaclotida (aprobada para mayores de 6 a\u00f1os), lubiprostona y plecanatida, que aumentan la secreci\u00f3n intestinal. Otros f\u00e1rmacos, como prucaloprida (agonista 5HT-4) y piridostigmina, buscan mejorar la motilidad. Las terapias rectales e intervencionistas incluyen la irrigaci\u00f3n transanal -que muestra buenos resultados-, los enemas anter\u00f3grados y la inyecci\u00f3n de toxina botul\u00ednica A, \u00fatiles para disfunciones espec\u00edficas. La biorretroalimentaci\u00f3n sigue siendo una herramienta efectiva. La neuromodulaci\u00f3n se posiciona como una opci\u00f3n prometedora. La estimulaci\u00f3n del nervio sacro implantada y las t\u00e9cnicas no invasivas como la estimulaci\u00f3n percut\u00e1nea\/transcut\u00e1nea del nervio tibial posterior y la neuroestimulaci\u00f3n transcut\u00e1nea sacra demuestran mejoras en los s\u00edntomas y la calidad de vida. Existen terapias poco exploradas pero prometedoras a futuro como la c\u00e1psula vibratoria, la neuroestimulaci\u00f3n magn\u00e9tica y los enfoques mente-cuerpo como la hipnosis. Es crucial la investigaci\u00f3n pedi\u00e1trica espec\u00edfica y un enfoque individualizado del tratamiento para optimizar la adherencia y los resultados en estos pacientes complejos.<\/jats:p>","DOI":"10.52787\/agl.v56i1.576","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T18:57:48Z","timestamp":1774983468000},"page":"41-56","source":"Crossref","is-referenced-by-count":0,"title":["Avances en el tratamiento del estre\u00f1imiento refractario pedi\u00e1trico"],"prefix":"10.52787","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6494-2839","authenticated-orcid":false,"given":"Cecilia","family":"Zubiri","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anabella","family":"Zosi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rom\u00e1n","family":"Bigliardi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"30608","published-online":{"date-parts":[[2026,3,31]]},"container-title":["Acta Gastroenterol\u00f3gica Latinoamericana"],"original-title":[],"link":[{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/download\/576\/944","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/download\/576\/959","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/download\/576\/959","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T18:57:49Z","timestamp":1774983469000},"score":1,"resource":{"primary":{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/view\/576"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3,31]]}},"URL":"https:\/\/doi.org\/10.52787\/agl.v56i1.576","relation":{},"ISSN":["2469-1119"],"issn-type":[{"value":"2469-1119","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,31]]}}}