Functional constipation in children: a mini-review for primary care management

Abstract

Functional constipation is one of the most common chronic gastrointestinal complaints encountered in childhood and remains a frequent reason for primary-care consultation. Although often benign, the condition can place a substantial burden on affected children and their families due to discomfort, behavioral changes around toileting, school difficulties, and anxiety related to symptoms. Many children experience cycles of painful defecation followed by voluntary stool withholding, which perpetuates rectal distension and harder stools. Understanding these behavioral and physiological components is essential for guiding effective management in community settings, where most cases initially present. This mini-review provides an overview of current concepts related to epidemiology, clinical presentation, and the natural course of functional constipation in children. Practical diagnostic approaches suited for primary-care practice are emphasized, including recognition of key alarm features that warrant further evaluation or referral. The review outlines evidence-based therapeutic strategies that integrate education, toilet routines, dietary adjustments, and pharmacologic options. The role of behavioral reinforcement, family guidance, and school-based support is also highlighted to address the psychosocial aspects of the condition. Long-term follow-up and prevention of relapse are critical components of successful care, especially during periods of illness, travel, or routine disruption. Practical tools such as stool diaries, school coordination, and structured plans for recurrent symptoms can improve adherence and outcomes. By summarizing clinically relevant recommendations and providing an accessible framework for stepwise management, this review aims to support clinicians in delivering consistent, effective, and family-centered care for children with functional constipation.