Constipation in XXXX : novel insight into epidemiology, pathophysiology and management.

@entity1 @entity1142
Constipation in @entity1 is a common health problem affecting 0.7% to 29.6% @entity1 across the world. Exact etiology for developing symptoms is not clear in @entity1 and the majority is considered to have functional @entity1142 . Alteration of rectal and pelvic floor function through the brain-gut axis seems to play a crucial role in the etiology. The diagnosis is often a symptom-based clinical process. Recently developed Rome III diagnostic criteria looks promising, both in clinical and research fields. Laboratory investigations such as barium enema, colonoscopy, anorectal manometry and colonic transit studies are rarely indicated except in those who do not respond to standard management. Treatment of childhood @entity1142 involves several facets including education and demystification, toilet training, rational use of laxatives for disimpaction and maintenance and regular follow-up. Surgical options should be considered only when medical therapy fails in long standing @entity1142 . Since most of the management strategies of childhood @entity1142 are not evidence-based, high-quality randomized controlled trials are required to assess the efficacy of currently available or newly emerging therapeutic options. Contrary to the common belief that @entity1 outgrow @entity1142 as they grow up, a sizable percentage continue to have symptoms beyond puberty.
