Effectiveness of Diet and Lifestyle modifications in Children with Chronic Idiopathic Constipation

Bibliographic InformationReason for rejecting study
Elia et al. Systematic review and meta-analysis: the clinical and physiological effects of fibre-containing enteral formulae. 2008. Alimentary Pharmacology and Therapeutics 27[2], 120-145Population out of remit of guideline: healthy volunteers and hospitalised tube-fed patients
McEligot et al. High dietary fiber consumption is not associated with gastrointestinal discomfort in a diet intervention trial. 2002. Journal of the American Dietetic Association 102[4], 549-551Adult population
Elawad et al. Management of constipation in children with disabilities. 2001. Developmental Medicine and Child Neurology 43[12], 829-832United Kingdom.Non systematic review paper. References checked
Mooren et al. The connection between dietary fibre intake and chronic constipation in children. 1996. Nederlands Tijdschrift voor Geneeskunde 140[41], 2036-2039Paper in Dutch
Moore et al. Effects of fructo-oligosaccharide-supplemented infant cereal: A double-blind, randomized trial. 2003. British Journal of Nutrition 90[3], 581-587United Kingdom.Healthy children
Payler et al. The effect of wheat bran on intestinal transit. 1975. Gut 16[3], 209-213Healthy population (both children and adults)
Turunen et al. Lymphoid nodular hyperplasia and cow's milk hypersensitivity in children with chronic constipation. 2004. Journal of Pediatrics 145[5], 606-611Paper also excluded from the cow's milk review as excluding cow's milk was combined with laxative administration. Clinical outcomes poorly reported. Results mainly concerned with histological outcomes
Rubin et al. Chronic constipation in children. 2006. British Medical Journal 333[7577], 1051-1055United Kingdom.Non systematic review paper
Williams. Importance of dietary fiber in childhood. 1995. Journal of the American Dietetic Association 95[10], 1140-1146United States.Non systematic review paper. References checked
Ling et al. Dietary treatment of diarrhea and constipation in infants and children. 1978. Issues in Comprehensive Pediatric Nursing 3[4], 17-28Non systematic review paper. References checked
Rubin. Constipation in children. 2003. Clinical Evidence [10], 369-374Clinical evidence update search and appraisal: Found no RCTs or SR on the effects of increasing dietary fibre in children
Rubin. Constipation. 2002. Clinical Evidence [8], 313-318Clinical evidence update search and appraisal: Found no RCTs or SR on the effects of increasing dietary fibre in children
Stark et al. Evaluation of a standard protocol for retentive encopresis: a replication. 1997. Journal of Pediatric Psychology 22[5], 619-633Combined intervention: mainly behavioural psychological programme + enema use. Only dietary component consisted on instructing parents on how to provide adequate fibre intake to children, but no other details provided.
Hillemeier. An overview of the effects of dietary fiber on gastrointestinal transit. 1995. Pediatrics 96[5 Pt 2], 997-999Non systematic review paper. References checked
Liebl et al. Dietary fiber and long-term large bowel response in enterally nourished nonambulatory profoundly retarded youth. 1990. Journal of Parenteral and Enteral Nutrition 14[4], 371-375Population outside remit of guideline: all children nourished via gastrostomy tubes, non ambulatory, severely mentally disabled, and received high doses of anticonvulsants
Fischer et al. The effects of dietary fibre in a liquid diet on bowel function of mentally retarded individuals. 1985. Journal of Mental Deficiency Research 29[Pt 4], 373-381Population outside remit of guideline: all children tube-fed, non-ambulant, severely or profoundly mentally disabled
Houts et al. Use of dietary fiber and stimulus control to treat retentive encopresis: a multiple baseline investigation. 1988. Journal of Pediatric Psychology 13[3], 435-445Very small sample size: 3 children only. Combined interventions: increasing dietary fibre and water intake + scheduled toilet training + contingent used of suppositories. Better studies available
Heine. Gastroesophageal reflux disease, colic and constipation in infants with food allergy. 2006. Current Opinion in Allergy and Clinical Immunology 6[3], 220-225United States.Non systematic review paper. References checked
Badiali et al. Effect of wheat bran in treatment of chronic nonorganic constipation. A double-blind controlled trial. 1995. Digestive Diseases and Sciences 40[2], 349-356Adult population
Olness et al. Chronic constipation in children: can it be managed by diet alone? 1982. Postgraduate Medicine 72[4], 149-154Prospective case series. Multiple interventions and outcomes poorly reported. Better studies available
Crowley et al. Evidence for a role of cow's milk consumption in chronic functional constipation in children: systematic review of the literature from 1980 to 2006. 2008. Nutrition and Dietetics 65[1], 29-35Excluded as systematic review as it includes papers that we have previously included and vice versa. References checked
Zoppi et al. Potential complications in the use of wheat bran for constipation in infancy. 1982. Journal of Pediatric Gastroenterology and Nutrition 1[1], 91-95Very small sample size (6 children). No clinical outcomes on effectiveness
Guimaraes et al. Dietary fiber intake, stool frequency and colonic transit time in chronic functional constipation in children. 2001. Brazilian Journal of Medical and Biological Research 34[9], 1147-1153Poor quality observational study. Better intervention studies available
Chao et al. Cutoff volume of dietary fiber to ameliorate constipation in children. 2008. Journal of Pediatrics 153[1], 45-49Poor methodological study. Better studies available
Iacono et al. Persistent cow's milk protein intolerance in infants: the changing faces of the same disease. 1998. Clinical and Experimental Allergy 28[7], 817-823Retrospective cohort. Clinical outcomes poorly reported
Mellon et al. Treatment of retentive encopresis with diet modification and scheduled toileting vs. mineral oil and rewards for toileting: A clinical decision. 1996. Ambulatory Child Health 1[3], 214-222United Kingdom.Combined interventions: laxatives + rewards vs. diet modification + scheduled toilet training.
Speridiao et al. Dietary fiber, energy intake and nutritional status during the treatment of children with chronic constipation. 2003. Brazilian Journal of Medical and Biological Research 36[6], 753-759Brazil.Prospective case series. Combined interventions: laxative+ dietary modifications.
Morais et al. Measurement of low dietary fiber intake as a risk factor for chronic constipation in children. 1999. Journal of Pediatric Gastroenterology and Nutrition 29[2], 132-135Case-control study. Better quality papers already included
Moro et al. Dosage-related bifidogenic effects of galacto- and fructooligosaccharides in formula-fed term infants. 2002. Journal of Pediatric Gastroenterology and Nutrition 34[3], 291-295Healthy children
Aggett et al. Nondigestible carbohydrates in the diets of infants and young children: a commentary by the ESPGHAN Committee on Nutrition. 2003. Journal of Pediatric Gastroenterology and Nutrition 36[3], 329-337Non systematic review paper. References checked
Edwards et al. Dietary fibre in infancy and childhood. 2003. Proceedings of the Nutrition Society 62[1], 17-23Non systematic review paper. References checked
Tabbers et al. Effect of the consumption of a fermented dairy product containing Bifidobacterium lactis DN-173 010 on constipation in childhood: A multicentre randomised controlled trial (NTRTC: 1571). 2009. BMC Pediatrics 9[1]United Kingdom.Study protocol only
Borrelli et al. Neuroimmune interaction and anorectal motility in children with food allergy-related chronic constipation. 2009. American Journal of Gastroenterology 104[2], 454-463United Kingdom.Apart from cow's milk other food exclude at the same time (eggs and soy protein). Results after carrying out specific double-blind placebo controlled challenges no reported

From: Appendix K, Excluded studies

Cover of Constipation in Children and Young People
Constipation in Children and Young People: Diagnosis and Management of Idiopathic Childhood Constipation in Primary and Secondary Care.
NICE Clinical Guidelines, No. 99.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2010.
Copyright © 2010, National Collaborating Centre for Women's and Children's Health.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK [www.cla.co.uk]. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.