The role of physical therapy in the treatment of children with chronic functional constipation

Chronic constipation is a common, frustrating and time consuming problem in childhood. Despite the standard medical treatment, 50% of children continued to be constipated after a five-year follow-up. Since dysfunction of the PFMs is the major reason for FFR in children, physiotherapy interventions might play an important role to increase the success rate. They include diaphragmatic breathing, pelvic floor exercises with or without biofeedback to teach children awareness, proper muscle function and relaxation during defecation. Although the mechanism of interferential current action is not completely understood, positive effects include increase in defecation frequency, improvement in rectal sensory perception, reduction in fecal incontinence and abdominal pain. As these effects might last up to 2 years, interferential currents are considered to be effective modality in the management of chronic functional constipation in children. New, randomized, controlled clinical trials are needed to confirm the promising role of physical modalities in the treatment of constipated pediatric patients.