Measuring the symptoms of pediatric constipation and irritable bowel syndrome with constipation: expert commentary and literature review

Patient. 2014;7(4):343-64. doi: 10.1007/s40271-014-0070-3.

Abstract

Background: Symptom measurement in pediatric chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C) trials requires appropriately developed clinical outcome assessments (COAs).

Methods: Literature was reviewed to identify symptom COAs meeting regulatory standards. Searches were conducted in Pubmed/Medline, EMBASE, and PsychINFO. Title/abstracts were reviewed to identify qualitative studies and those using COAs to measure pediatric CIC/IBS symptoms. Pediatric functional gastrointestinal experts provided input on relevant symptom-concepts to measure.

Results: Review of 1,105 abstracts identified 1 relevant qualitative article and 113 articles including COAs. Symptoms most frequently measured in CIC studies were frequency of bowel movements, fecal incontinence/encopresis, abdominal pain, stool consistency, and painful defecation. Symptoms most frequently measured in IBS were abdominal pain, abdominal distention/bloating, stool consistency, frequency of bowel movements, and gas. Evidence of development/validity of COAs was limited. Expert feedback was broadly consistent with the literature.

Conclusion: Findings demonstrate consistency in the literature on key CIC/IBS symptoms to measure in pediatric trials, but existing COAs do not meet regulatory standards.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Abdominal Pain
  • Adolescent
  • Child
  • Child, Preschool
  • Chronic Disease
  • Constipation / therapy*
  • Humans
  • Infant
  • Irritable Bowel Syndrome / therapy*
  • Outcome Assessment, Health Care / methods*
  • Pediatrics
  • Severity of Illness Index
  • Treatment Outcome