Kabızlık Nedeni Olan Beslenme Faktörleri
Özet
Fonksiyonel kabızlık, çocukluk çağında en sık görülen gastrointestinal bozukluklardan biridir ve gelişiminde beslenme önemli bir rol oynamaktadır. Bu bölümde çocukluk çağı kabızlığı ile ilişkili başlıca beslenme faktörleri güncel kanıtlar doğrultusunda ele alınmıştır. Diyet lifi ve sıvı alımı, süt ve süt ürünleri tüketimi, meyve-sebze ve sorbitol içeren besinlerin tüketimi, Batı tipi beslenme modeli, ultra işlenmiş gıdalar, obezite, sedanter yaşam tarzı, gelişimsel beslenme geçişleri ve bağırsak mikrobiyotası ile kabızlık arasındaki ilişkiler değerlendirilmiştir. Güncel kanıtlar, çocukluk çağı fonksiyonel kabızlığının önlenmesi ve yönetiminde yaşa uygun, liften zengin ve dengeli beslenmenin, yeterli hidrasyonun ve sağlıklı yaşam tarzı alışkanlıklarının temel yaklaşım olduğunu göstermektedir.
Referanslar
Altındağ V. Çocuk Polikliniklerine Başvuran Hastalarda Kabızlık Sıklığı ve Etkileyen Faktörlerin Araştırılması [Tıpta Uzmanlık Tezi]. İstanbul Üniversitesi-Cerrahpaşa; 2024.
Tran DL, Sintusek P. Functional constipation in children: What physicians should know. World J Gastroenterol. 2023;29(8):1261-1288. doi:10.3748/wjg.v29.i8.1261
Gordon M, de Geus A, Banasiuk M, et al. ESPGHAN and NASPGHAN 2024 protocol for paediatric functional constipation treatment guidelines (standard operating procedure). BMJ Paediatr Open. 2025;9(1):e003161.
Akbulut E. Dışkılama Zorluğu Olan Bebeklerin Annelerindeki Anksiyete ve Fonksiyonel Kabızlık Durumları [Tıpta Uzmanlık Tezi]. Sağlık Bilimleri Üniversitesi; 2024.
Atar Beşe S. Primer Enürezis Tanılı Çocuklarda Alt Üriner Sistem Semptomları, Gündüz İdrar Kaçırma ve Kabızlık Oranları [Tıpta Uzmanlık Tezi]. Sağlık Bilimleri Üniversitesi; 2019.
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.
Rajindrajith S, Devanarayana MM, Benninga MA. Childhood constipation: Current status, challenges, and future perspectives. World J Clin Pediatr. 2022;11(5):385-404.
Neves RO, Nunes LM, Silveira LO, Lima MR, Moreira PR, Bernardi JR. Functional constipation symptoms and complementary feeding methods: A randomized clinical trial. An Pediatr (Engl Ed). 2023;98(4):267-275.
Nurko S, Benninga MA, Solari T, Chumpitazi BP. Pediatric aspects of nutrition interventions for disorders of gut-brain interaction. Am J Gastroenterol. 2022;117(6):995-1009.
Leung AK, Hon KL. Paediatrics: how to manage functional constipation. Drugs Context. 2021;10:2020-11-2.
Chowdhury K, Sinha S, Kumar S, Haque M, Ahmad R. Constipation: A pristine universal pediatric health delinquent. Cureus. 2024;16(1):e52551.
Gill SK, Rossi M, Bajka B, et al. Dietary fibre in gastrointestinal health and disease. Nat Rev Gastroenterol Hepatol. 2021;18(2):101–116.
Martínez L, et al. Dietary fibers, gut microbiota composition, and gastrointestinal motility in pediatric populations. J Nutr Biochem. 2023;112:109-118.
van Dijk M, et al. The impact of dietary habits on treatment compliance and long-term outcomes in childhood functional constipation. Gastroenterol Res Pract. 2024;2024:451298.
Hojsak I, Benninga MA, Hauser B, et al. Benefits of dietary fibre for children in health and disease. Arch Dis Child. 2022;107(11):973–979.
Piccoli de Mello P, Eifer DA, Daniel de Mello E. Use of fibers in childhood constipation treatment: systematic review with meta-analysis. J Pediatr (Rio J). 2018;94(5):460-470.
Lai H, Li Y, He Y, et al. Effects of dietary fibers or probiotics on functional constipation symptoms and roles of gut microbiota: a double-blinded randomized placebo trial. Gut Microbes. 2023;15(1):2192531.
Yerlikaya FH. Mikrobiyota metaboliti: Kısa zincirli yağ asitleri. Selçuk Sağlık Derg. 2024;5(3):393–419.
Yang J, Wang HP, Zhou L, Xu CF. Effect of dietary fiber on constipation: A meta-analysis. World J Gastroenterol. 2012;18(48):7378-7383.
Yılmaz MS. Diyet lifleri: Tanımı, türleri ve gıda endüstrisinde kullanımları. Osmaniye Korkut Ata Üniv Fen Bilim Enst Derg. 2024;7(2):924-952.
Mercado-Perez A, Beyder A. Gut feelings: mechanosensing in the gastrointestinal tract. Nat Rev Gastroenterol Hepatol. 2022;19(5):283–296.
Salvatore S, Battigaglia MS, Murone E, Dozio E, Pensabene L, Agosti M. Dietary fibers in healthy children and in pediatric gastrointestinal disorders: a practical guide. Nutrients. 2023;15(9):2208.
Wegh CAM, Baaleman DF, Tabbers MM, Smidt H, Benninga MA. Nonpharmacologic treatment for children with functional constipation: A systematic review and meta-analysis. J Pediatr. 2022;240:136–149.e5.
Portincasa P, Bonfrate L, Vacca M, et al. Gut microbiota and short chain fatty acids: Implications in glucose homeostasis. Int J Mol Sci. 2022;23(3):1105.
Tan J, Macia L, Mackay C. Dietary fiber and SCFAs in the regulation of mucosal immunity. J Allergy Clin Immunol. 2022;151(2):361-370.
Zhang S, Wang R, Li D, Zhao L, Zhu L. Role of gut microbiota in functional constipation. Gastroenterol Rep. 2021;9(5):392–401.
Kranz S, Brauchla M, Slavin JL, Miller KB. What do we know about dietary fiber intake in children and health? The effects of fiber intake on constipation, obesity, and diabetes in children. Adv Nutr. 2012;3(1):47–53.
Williams CL, Bollella M, Wynder EL. A new recommendation for dietary fiber in childhood. Pediatrics. 1995;96(5 Pt 2):985–988.
Boilesen SN, Tahan S, Dias FC, Melli LCFL, de Morais MB. Water and fluid intake in the prevention and treatment of functional constipation in children and adolescents: is there evidence?. J Pediatr (Rio J). 2017;93(4):320–327.
Tabbers MM, DiLorenzo C, Berger MY, et al. Evaluation and treatment of functional constipation in infants and children: Evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 2014;58(2):258-274.
Iacono G, Cavataio F, Montalto G, et al. Intolerance of cow's milk and chronic constipation in children. N Engl J Med. 1998;339(16):1100–1104.
Connor F, Salvatore S, D’Auria E, Baldassarre ME, Acunzo M, Di Bella G, Farella I, Sestito S, Pensabene L. Cows’ Milk Allergy-Associated Constipation: When to Look for It? A Narrative Review. Nutrients. 2022; 14(6):1317. https://doi.org/10.3390/nu14061317
Hao L, Wang S, Ji W. Cow's milk protein allergy: A comprehensive review of epidemiology, pathogenesis, clinical manifestations, diagnostics, and management strategies. Asia Pac J Clin Nutr. 2025;34(3):298–307.
Günaydın NC. İnek sütü alerjisine güncel yaklaşım. Namık Kemal Üniv Tıp Fak Çocuk Sağ Hast Derg. 2019;1(1):15-28.
Gülsen N. 4-24 Ay Arası Süt Çocuklarının Beslenme Alışkanlıklarının Değerlendirilmesi ve İnfantil Kolik, Fonksiyonel İshal ve Fonksiyonel Kabızlık Açısından Sorgulanması [Tıpta Uzmanlık Tezi]. İstanbul Eğitim ve Araştırma Hastanesi; 2019.
Mulhem E, Khondoker F, Kandiah S. Constipation in children and adolescents: Evaluation and treatment. Am Fam Physician. 2022;105(5):469-476.
Mutyala R, Sanders K, Bates MD. Assessment and management of pediatric constipation for the primary care clinician. Curr Probl Pediatr Adolesc Health Care. 2020;50(5):100802. doi:10.1016/j.cppeds.2020.100802.
Mohammadi Bourkheili A, Mehrabani S, Esmaeili Dooki M, Haji Ahmadi M, Moslemi L. Effect of cow's-milk-free diet on chronic constipation in children; A randomized clinical trial. Caspian J Intern Med. 2021;12(1):91–96.
Dehghani SM, Ahmadpour B, Haghighat M, Kashef S, Imanieh MH, Soleimani M. The role of cow's milk allergy in pediatric chronic constipation: A randomized clinical trial. Iran J Pediatr. 2012;22(4):468–474.
Bae SH. Diets for constipation. Pediatr Gastroenterol Hepatol Nutr. 2014;17(4):203–208.
Taylor CM, Emmett PM. Picky eating in children: causes and consequences. Proc Nutr Soc. 2019;78(2):161–169.
Inan M, Aydiner CY, Tokuc B, et al. Factors associated with childhood constipation. J Paediatr Child Health. 2007;43(10):700–706.
Huo J, Wu L, Lv J, Cao H, Gao Q. Effect of fruit intake on functional constipation: A systematic review and meta-analysis of randomized and crossover studies. Front Nutr. 2022;9:1018502.
Sayre CL, Yellepeddi VK, Job KM, et al. Current use of complementary and conventional medicine for treatment of pediatric patients with gastrointestinal disorders. Front Pharmacol. 2023;14:1051442.
Chien LY, Liou YM, Chang P. Low defaecation frequency in Taiwanese adolescents: Association with dietary intake, physical activity and sedentary behaviour. J Paediatr Child Health. 2011;47(6):381-386.
Andreoli CS, Vieira-Ribeiro SA, Fonseca PCA, et al. Eating habits, lifestyle and intestinal constipation in children aged four to seven years. Hábitos alimentarios, estilo de vida y estreñimiento intestinal en niños de cuatro a siete años. Nutr Hosp. 2019;36(1):25-31. doi:10.20960/nh.02059.
Calcaterra V, Cena H, Ferrara C, et al. Highly processed food and functional gastrointestinal disorders in children and adolescents with obesity: The preventive challenge—A narrative review. Nutrients. 2025;17(23):3744.
Misra S, Lee A, Gensel K. Chronic constipation in overweight children. JPEN J Parenter Enteral Nutr. 2006;30(2):81-84.
Pashankar DS, Loening-Baucke V. Increased prevalence of obesity in children with functional constipation evaluated in an academic medical center. Pediatrics. 2005;116(3):e377-e380.
Teitelbaum J, Sinha P, Micale M, et al. Obesity is related to multiple functional abdominal diseases. J Pediatr. 2009;154(3):444-446.
Driessen LM, Kiefte-de Jong CC, Wijtzes A, et al. Preschool physical activity and functional constipation: the Generation R study. J Pediatr Gastroenterol Nutr. 2013;57(6):768-774.
Moretti E, Rakza T, Mestdagh B, Labreuche J, Turck D. The bowel movement characteristics of exclusively breastfed and exclusively formula fed infants differ during the first three months of life. Acta Paediatr. 2019;108(5):877-881.
Wichmann A. Biological effects of combinations of structurally diverse human milk oligosaccharides. Front Pediatr. 2024;12:1439612.
Nowacki J, Lee HC, Lien R, et al. Stool fatty acid soaps, stool consistency and gastrointestinal tolerance in term infants fed infant formulas containing high sn-2 palmitate with or without oligofructose: a double-blind, randomized clinical trial. Nutr J. 2014;13:105.
Crowley R, et al. Cow’s milk protein-induced alterations in gut motility: Immunological pathways and physiological implications. Pediatr Res. 2008;64(2):154-160.
Sangalli CN, Leffa PDS, Morais MB, Vitolo MR. Infant Feeding Practices and the Effect in Reducing Functional Constipation 6 Years Later: A Randomized Field Trial. J Pediatr Gastroenterol Nutr. 2018;67(5):660-665. doi:10.1097/MPG.0000000000002075.
de Meij TGJ, de Groot EFJ, Eck A, et al. Characterization of microbiota in children with chronic functional constipation. PLoS One. 2016;11(10):e0164731.
Nguyen T, et al. Multi-pathway analysis of the pediatric gut microbiome in functional gastrointestinal disorders. Guts Microbes. 2026;18(1):45-56.
Taylor CM, Northstone K, Wernimont SM, Emmett PM. Picky eating in preschool children: Associations with dietary fibre intakes and stool hardness. Appetite. 2016;100:263-271. doi:10.1016/j.appet.2016.02.021
de Moraes JG, Motta ME, Beltrão MF, Salviano TL, da Silva GA. Fecal microbiota and diet of children with chronic constipation. Int J Pediatr. 2016;2016:6787269.
Szajewska H, Berni Canani R, Domellöf M, et al. Probiotics for the management of pediatric gastrointestinal disorders: Position paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications. J Pediatr Gastroenterol Nutr. 2023;76(2):232-247.
Guarner F, Sanders ME, Szajewska H, et al. World Gastroenterology Organisation Global Guidelines: Probiotics and Prebiotics. J Clin Gastroenterol. 2024;58(6):533-553. Published 2024 Jul 1. doi:10.1097/MCG.0000000000002002.
Liang C, Deng X, Wang H, et al. Efficacy and safety of probiotics, prebiotics and synbiotics for the treatment of functional constipation in children: Systematic review and network meta-analysis. Probiotics Antimicrob Proteins. 2026; Online ahead of print.
