Patterns and predictors of surgical management in pediatric chronic idiopathic constipation.
- 1Division of Pediatric Surgery, Department of Surgery, University of Virginia, Charlottesville, VA, United States.
- 2Department of Pediatric Surgery, Texas Children's Hospital, Houston, TX, United States.
Abstract
Introduction
Chronic idiopathic constipation (CIC) is a common childhood gastrointestinal disorder that substantially affects quality of life and healthcare utilization. Most children are managed successfully with dietary modification, behavioral interventions, and medical therapies. However, many patients experience severe or refractory symptoms that necessitate surgical intervention. We sought to identify patient factors associated with progression to surgical intervention.Methods
A retrospective multi-institutional cohort study was performed of children (<18 years of age) who presented to a pediatric surgeon for chief complaint of CIC between 2017 and 2022. The primary outcome was major surgical intervention for the management of CIC. Patient characteristics, including demographic characteristics and clinical variables, were queried, and multivariable logistic regression was used to assess the association between patient factors and surgical intervention.Results
A total of 188 patients were included. Forty patients (21.3%) had a major operation for CIC, including antegrade continence enema (ACE) procedures, intestinal resection, and intestinal diversion. Patients who underwent surgery were older at the time of first visit (mean 9.12 vs. 4.64 years; p < 0.001). In multivariable logistic regression, older age at first pediatric surgery visit was independently associated with surgical intervention. Each additional year of age was associated with approximately 30% higher adjusted odds of surgical intervention (adjusted OR 1.29, 95% CI 1.14-1.48; p < 0.001). Sex, race, ethnicity, insurance type, and neurodiversity were not significantly associated with surgery.Conclusion
Approximately one in five patients referred to a pediatric surgeon for refractory constipation undergo surgical intervention to treat constipation. Older age at presentation was associated with surgical treatment.
Related
- Genetic Predictors of Curve Progression and Brace Treatment Response in Adolescent Idiopathic Scoliosis: Toward Personalized Management
- Gut relief revisited: plecanatide in chronic idiopathic constipation and irritable bowel syndrome with constipation — a systematic review and meta-analysis with GRADE assessment
- Surgical Management of Pediatric Foot Macrodactyly: A Case Series Highlighting Variable Growth Patterns and Soft-Tissue Challenges
- Predictors of Response to Corticosteroid Therapy in Idiopathic Granulomatous Mastitis: A Retrospective Cohort Study of 176 Patients
- Nursing interventions for pediatric functional constipation: a systematic review of evidence and clinical implications
BibTeX
@article{obidike2026patterns,
title = {{Patterns and predictors of surgical management in pediatric chronic idiopathic constipation.}},
author = {Prisca C Obidike and Katlyn A Droke and Grant F Williams and Cecily A Wainstein and Trevor C Jones and Zoë Hemmer and Alison Jung and Bea B Jeon and Kristy L Rialon and Lily S Cheng},
journal = {Frontiers in pediatrics},
year = {2026},
month = oct,
doi = {10.3389/fped.2026.1955197},
url = {https://europepmc.org/article/MED/42909081},
note = {CC BY},
}
RIS
TY - JOUR
TI - Patterns and predictors of surgical management in pediatric chronic idiopathic constipation.
AU - Prisca C Obidike
AU - Katlyn A Droke
AU - Grant F Williams
AU - Cecily A Wainstein
AU - Trevor C Jones
AU - Zoë Hemmer
AU - Alison Jung
AU - Bea B Jeon
AU - Kristy L Rialon
AU - Lily S Cheng
PY - 2026
DA - 2026/10/07
JO - Frontiers in pediatrics
DO - 10.3389/fped.2026.1955197
UR - https://europepmc.org/article/MED/42909081
AB - Introduction Chronic idiopathic constipation (CIC) is a common childhood gastrointestinal disorder that substantially affects quality of life and healthcare utilization. Most children are managed successfully with dietary modification, behavioral interventions, and medical therapies. However, many patients experience severe or refractory symptoms that necessitate surgical intervention. We sought to identify patient factors associated with progression to surgical intervention.Methods A retrospective multi-institutional cohort study was performed of children (<18 years of age) who presented to a pediatric surgeon for chief complaint of CIC between 2017 and 2022. The primary outcome was major surgical intervention for the management of CIC. Patient characteristics, including demographic characteristics and clinical variables, were queried, and multivariable logistic regression was used to assess the association between patient factors and surgical intervention.Results A total of 188 patients were included. Forty patients (21.3%) had a major operation for CIC, including antegrade continence enema (ACE) procedures, intestinal resection, and intestinal diversion. Patients who underwent surgery were older at the time of first visit (mean 9.12 vs. 4.64 years; p < 0.001). In multivariable logistic regression, older age at first pediatric surgery visit was independently associated with surgical intervention. Each additional year of age was associated with approximately 30% higher adjusted odds of surgical intervention (adjusted OR 1.29, 95% CI 1.14-1.48; p < 0.001). Sex, race, ethnicity, insurance type, and neurodiversity were not significantly associated with surgery.Conclusion Approximately one in five patients referred to a pediatric surgeon for refractory constipation undergo surgical intervention to treat constipation. Older age at presentation was associated with surgical treatment.
SN - 2296-2360
ER -