ArticleBMJ paediatrics open2026
Refractory/therapy-resistant/intractable constipation in children.
Article in BMJ paediatrics open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
introductionA better understanding of key concepts is required to properly characterise intractable constipation (IC). We aimed to determine how IC is defined by Latin and Ibero-American paediatric gastroenterologists.
methodsA questionnaire was administered to evaluate concepts supporting the definition and use of a unified term for IC. The collected data were analysed using univariate and bivariate analyses. ORs with their corresponding 95% CIs were calculated, p values <0.05 were statistically significant.
resultsA total of 429 paediatric gastroenterologists participated: 45.7% Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) members (group 1), 16.3% Ibero-American LASPGHAN members (group 2) and 38.0% non-LASPGHAN affiliates (group 3). Most respondents considered lower bowel frequency despite receiving 'optimal medical treatment' (94.6%), with 51.0% indicating a period of 2-3 months; defined 'prior treatment failure' as the use of two laxatives (51.7%); selecting the tertiary level care prior to diagnosis (43.1%); wished to include the term 'optimal medical treatment' for diagnostic criteria (93.0%); believed follow-up should be carried out by a paediatrician/specialist (86.7%) and preferred the term refractory constipation (86.7%). When comparing group 1 versus group 2, the Spanish group preferred the term 'treatment-resistant constipation' (OR=1.96; 95% CI 1.08 to 3.55; p=0.0157).
conclusionsLatin and Ibero-American paediatric gastroenterologists prefer replacing the term 'IC' with 'refractory/treatment-resistant constipation' defined as a form of paediatric FC characterised by the persistence of clinically relevant symptoms despite optimal conventional medical treatment, appropriately prescribed, supervised and adhered to for a minimum period of 2-3 months, after structural, neurological and metabolic organic causes have been excluded.
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