A child with chronic functional constipation – a challenge for a pediatrician alone or a surgeon as well? Case series and literature review

Introduction
The role of surgical treatment for chronic functional constipation in children remains unclear. The objective of this study was to analyze clinical cases of patients qualified for surgical treatment.

Material and methods
We analized data of 160 pediatric patients hospitalized in 2013–2021. Thirteen patients subjected to surgical treatment.

Results
The study group consisted of 13 children. Organic causes of constipation were excluded. The duration of problems before qualification for surgical treatment averaged at 5.7 ±2.7 years. The most common symptoms were psychological disorders (13/13), abdominal pain (12/13) and fecal overflow incontinence (12/13). All patients were qualified for stepwise treatment: colostomy formation, segmental resection, and stoma closure. All children experienced subjective functional improvement. No severe surgical complications were observed.

Conclusions
In cases of functional constipation refractory to conservative treatment,, surgical treatment facilitates immediate improvement in symptoms and social functioning. Any surgical treatment should be preceded by the exclusion of organic causes of constipation.