Evidence

Surveillance report 2017 – Constipation in children and young people: diagnosis and management (2010) NICE guideline CG99

Surveillance decision

Surveillance decision

We will not update the guideline on constipation in children and young people at this time.

During surveillance editorial or factual corrections were identified. Details are included in appendix A: summary of evidence from surveillance.

Reason for the decision

Assessing the evidence

We found 84 studies through surveillance of this guideline.

This included evidence not considered to impact on the guideline recommendations in the following areas:

  • the key components of history-taking and physical examination that would indicate idiopathic constipation or flag a serious underlying disorder

  • the prevalence of hypothyroidism and coeliac disease in children with chronic constipation

  • the diagnostic value of rectal biopsy, abdominal ultrasound and abdominal radiography in children with chronic constipation

  • pharmacological and surgical interventions for disimpaction

  • the use of polyethylene glycol (PEG) as a maintenance therapy

  • advice on physical activity, dietary fibre, fluid intake and a cows' milk exclusion diet for children with chronic idiopathic constipation

  • the use of psychological interventions

  • the use of antegrade colonic enemas

  • information, support and advice for young people and their parents and carers.

We found evidence on the following areas not covered in the guideline:

  • use of lubiprostone, prucalopride, cassia fistula's emulsion, oral domperidone or flixweed as a maintenance therapy for chronic constipation

  • transanal irrigation

  • electrical stimulation therapy

  • physiotherapy

  • probiotics and prebiotics.

This evidence was considered to be insufficient in volume and conclusive results to add new recommendations at this time.

We did not find any evidence related to the diagnostic value of gastrointestinal endoscopy, anorectal manometry or transit studies in children with chronic idiopathic constipation.

Equalities

No equalities issues were identified during the surveillance process.

Overall decision

After considering all the evidence and views of topic experts and stakeholders, we decided to not update this guideline at this time.

See how we made the decision for further information.


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