The Rome IV method is the main method for identifying constipation in children, but researchers point to a more effective way
Popularly known as “constipation”, constipation can affect both adults and children. Children, however, are diagnosed by the age of 4.
The main way to identify the problem in children is through the Rome IV method. The technique is adopted throughout the world and is based on six questions. If two responses are positive, there is an indication of constipation.
Rome Criteria IV
The questions describing the Rome IV criteria are:
- Are there two or fewer bowel movements per week?
- Do you have at least one episode of fecal incontinence per week?
- Is there a history of retentive posture or excessive voluntary fecal retention?
- Is there a large fecal mass in the rectal canal?
- Does your child have a history of large stools that could block the toilet?
- Are bowel movements painful?
If only one question is positive, a rectal examination is required for confirmation. It is worth noting that this approach, although effective in confirming it, does not offer an assessment of the degree of constipation.
New way to identify the problem
To overcome this limitation, a study developed at the Escola Bahiana de Medicina e Saúde Pública, published in the Journal of Pediatric Urology, adapted and validated the Cleveland Constipation Score (CCS) for pediatric use, originally developed to evaluate constipation in adults. CCS is a comprehensive tool that provides a more accurate diagnosis and eliminates the need for a digital rectal exam.
The study, published and validated for the pediatric population, offers an innovative alternative, allowing a more detailed assessment of constipation in children aged 4 or 5 years. By quantifying the intensity of constipation, CCS promises to be a valuable tool for diagnosing and monitoring this condition more accurately.
“We asked the author of the CCS for permission to adapt this tool to the pediatric population and he agreed,” says pediatric urologist Dr. Ubirajara Barroso. The doctor supervised the research, the result of the doctoral work of coloproctologist Glícia Abreu.
Researchers are negotiating with an American university to validate the score in English, which could make it the new global standard. “This initiative will not only broaden the scope of the tool, but also contribute to its global acceptance, representing a significant advance in the diagnostic approach to constipation in children,” he says.
Constipation in children
According to coloproctologist Glícia Abreu, children begin to have control over their defecation around the age of 3. “Treating constipation can be complex,” says the doctor. Additionally, approximately 40% of constipated children experience a relapse after a year of treatment for constipation.
“It has also been observed that 25% of constipated children become constipated adults and are often difficult to treat. Furthermore, those responsible often discontinue the necessary use of laxatives for fear of ‘the bowel getting used to it’!”, warns the doctor . .
Dr. Ubirajara Barroso Jr. points out that approximately 50% of children suffering from urinary incontinence also suffer from constipation. Therefore, it is necessary to treat both problems, since one interferes with the other.
Parasacral electroneurostimulation, used by Barroso Jr.’s team since 2001 to treat childhood urinary incontinence, has also proven effective in treating constipation.
“This is the first resource that treats both conditions together, as therapy for vesicointestinal dysfunction currently includes two treatment modalities, one for each problem,” explains Dr. Ubirajara.
“The literature also highlights that the treatment of constipation is a key point in the treatment of urinary symptoms,” concludes Dr. Glícia.
Source: Terra
Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
