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Johns Hopkins Center Focuses on Child Constipation

Cheryl Clark, for HealthLeaders Media, October 26, 2010

A surprising increase in the number of children with severe constipation has prompted Johns Hopkins Children's Center in Baltimore, MD to launch a multidisciplinary clinic to deal with what gastroenterologists there say is a trend.

Center officials say they are seeing children with the condition on a daily basis, with a 30% increase in related visits between 2008 and 2009.

"The reality is that too many children are either not treated at all, start treatment too late or are treated inadequately, leading to persistent, severe and chronic constipation," says Maria Oliva-Hemker MD, director of pediatric gastroenterology and nutrition at the center.

The clinic, which began this month, operates several days a month and sees five to six patients per day.

Gastroenterologists and other team members say they're seeing children with much more than mild constipation. The condition is easy to miss or ignore, but can have lifelong complications, resulting in more serious medical conditions in adulthood, including urinary tract infections, fecal incontinence, nausea, vomiting, headaches, abdominal distension, and flatulence.

Research demonstrates that children with constipation have a worse quality of life than children with more permanent medical conditions including inflammatory bowel disease and gastro-esophageal reflux.

Mathews says that the program is designed to help parents create a toilet routine for their child and to complement the medical treatment of the child.

"Over time, the goal is to gradually fade out the parental involvement and increase the child's independent toileting," Mathews says.

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