Çocuklarda Kabızlığın Davranışsal Etkenleri
Özet
Çocukluk çağı fonksiyonel kabızlığı (FK), yalnızca bir bağırsak motilite bozukluğu değil; biyolojik, psikolojik ve sosyal etkenlerin iç içe geçtiği çok boyutlu bir klinik tablodur. Bu bölümde dışkı tutma davranışı, tuvalet eğitimi süreci, psikolojik stres, ebeveynlik tutumları, aile dinamikleri ve sedanter yaşam tarzı gibi davranışsal etkenler güncel kanıtlar ışığında ele alınmıştır. Beyin-bağırsak ekseni aracılığıyla işleyen biyolojik mekanizmalar, bu davranışsal etkenlerin fizyolojik zeminini oluşturmaktadır. Davranışsal etkenlerin erken tanınması ve biyopsikososyal model çerçevesinde ele alınması, tedavi yanıtını iyileştirme ve kronikleşmeyi önleme açısından belirleyici öneme sahiptir.
Referanslar
Kilgore A, Khlevner J. Functional constipation: pathophysiology, evaluation, and management.
Aliment Pharmacol Ther. 2024;60(Suppl 1):S20–S29.
Mugie SM, Di Lorenzo C, Benninga MA. Constipation in childhood. Nat Rev Gastroenterol Hepatol. 2011;8(9):502–511.
Liyanarachchi H, Rajindrajith S, Kuruppu C, et al. Association between childhood constipation and stressful life events: a systematic review. Neurogastroenterol Motil. 2022;34(4):e14231.
Rajindrajith S, Devanarayana NM, Benninga MA. Childhood constipation: current status, challenges, and future perspectives. World J Clin Pediatr. 2022;11(5):385–404.
Tran DL, Sintusek P. Functional constipation in children: what physicians should know. World J Gastroenterol. 2023;29:1261–1288.
Al-Beltagi M, Saeed NK, Bediwy AS, et al. Breaking the cycle: Psychological and social dimen- sions of pediatric functional gastrointestinal disorders. World J Clin Pediatr. 2025;14(2):103323.
Mayer EA, Tillisch K, Gupta A. Gut/brain axis and the microbiota. J Clin Invest. 2015;125(3):926– 938.
Kilgore AL, Rogers Boruta MK, Ambartsumyan L, et al. Evaluation and management of pedi- atric refractory constipation: Recommendations from the NASPGHAN neurogastroenterology and motility committee. J Pediatr Gastroenterol Nutr. 2025;80(2):353–373.
Nurko S, Zimmerman LA. Evaluation and treatment of constipation in children and adoles- cents. Am Fam Physician. 2014;90(2):82–90.
Tabbers MM, DiLorenzo C, Berger MY, et al. Evaluation and treatment of functional constipa- tion in infants and children: evidence-based recommendations from ESPGHAN and NASPG- HAN. J Pediatr Gastroenterol Nutr. 2014;58(2):258–274.
Baffy N, Harris LA, Foxx-Orenstein AE. Pelvic floor dysfunction and refractory constipation. e-WGN Expert Point of View. 2017;22(1).
Rao SS, Bharucha AE, Chiarioni G, et al. Functional anorectal disorders. Gastroenterology. 2016;150(6):1430–1442.
Vriesman MH, Koppen IJN, Camilleri M, et al. Management of functional constipation in children and adults. Nat Rev Gastroenterol Hepatol. 2020;17(1):21–39.
Bashir SK, Khan MB. Pediatric functional constipation: a new challenge. Advanced Gut & Mic- robiome Research. 2024;2024:5569563.
Saber Sangari R, Hashemi M, Salehi B, et al. Anxiety disorders in children with functional constipation: a case-control study. J Compr Pediatr. 2022;13(2):e119997.
Sawyer G, Heron J, Joinson C. The relationship between maternal psychopathology and of- fspring incontinence and constipation at school age: A prospective cohort study. J Affect Disord. 2023;335:1–9.
Baumrind D. Child care practices anteceding three patterns of preschool behavior. Genet Psy- chol Monogr. 1967;75(1):43–88.
Cui J, Xie F, Yue H, et al. Physical activity and constipation: A systematic review of cohort stu- dies. J Glob Health. 2024;14:04197.
Hotta M, Ikehara S, Tachibana M, et al.; Japan Environment and Children’s Study Group. Asso- ciation between TV/DVD screen exposure time at age 1 and risk of chronic constipation at age 3: the Japan Environment and Children’s Study. Environ Health Prev Med. 2025;30.
Cinquetti M, Biasin M, Ventimiglia M, et al. Functional gastrointestinal disorders, lifestyle ha- bits, and smartphone addiction in adolescents. Pediatr Med Chir. 2021;43(1):238.
