الفهرس 
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Abstract
Background: Constipation represents a common problem in children. Constipation have variable etiologies, it could be functional and organic. Treatment include education of parents, diet modification, laxatives (osmotic &stimulant) and cow’s milk elimination.
Objectives: evaluate the outcome of different lines of treatment of constipation.
Subjects and Methods: we included 127 patients with functional constipation following in pediatric gasteroenterology clinic (Ain Shams University). we excluded patients with IBS, Organic causes of constipation Anatomical and anorectal surgeries.
Results: we found that 56 patients showed complete response on monotherapy. 8 patients (6.2%) responded to combination therapy,8 patients responded to elimination & 17 patients were intractable. the patients who responded to elimination diet had significantly younger median age & age at presentation & significantly higher frequency of allergic manifestation compared to those who responded to laxatives & intractable patients. Intractable cases had significantly higher frequency of fecal incontinence compared to those who responded to elimination.7 patients underwent botulinum toxin injection and all of them showed complete response.
Conclusion: Functional constipation is more common in male. the most common symptoms were hard stool &straining. Diet modification wasn’t successful alone for complete resolution of symptom. 44.1% of patients showed complete response to monotherapy ,6.3% responded to combination while 15.7% of patients had complete response to cow’s milk elimination. Criteria in favor for response to elimination diet included family history, allergic manifestation & younger age at presentation.