Complementary and alternative medicine (CAM) is frequently used by parents for the treatment of functional constipation in children

ObjectivesComplementary and alternative medicine (CAM) has gained increasing attention as a supportive treatment for chronic diseases such as epilepsy, migraine, autism, and cancer in children. This study aimed to determine the frequency, motivation, and outcomes of CAM in children with functional constipation.MethodsFrom January 2018 till September 2019, parents of patients (0-18 years) who were treated for functional constipation (ROME IV-criteria) at our colorectal center were asked to complete a questionnaire on the utilization of CAM. Demographic data and clinical assessments were documented and analyzed for patients with and without CAM treatment.ResultsA total of 115 patients were included (mean age: 5.1 years; 49% males), of whom 29 (25%) used CAM as an alternative (4/29,14%) or in addition to conventional therapy (CT), including osteopathy (48%), homeopathy (45%), and natural/herbal remedies (17%). The main reason parents reported for the use of CAM was the urge to leave no treatment option unattempted (76%). Multivariate analysis also identified persistent constipation under CT (72%), adverse effects of CT (24%), and parental use of CAM themselves (83%) as independent variables associated with CAM use. Parents reported positive changes in stool frequency (38%) and fecal incontinence (21%) with CAM. The vast majority (93%) plan to use CAM in the future, and even non-CAM users showed high interest (60%).ConclusionOne in four children with functional constipation receives CAM. Significant improvement in stool frequency and continence is missing in the majority. However, parental interest in CAM remains high. Physicians should be aware of CAM when counseling families for functional constipation in children. What is Known image Constipation can affect the child's quality of life and be a burden for the family. Complementary and alternative medicine (CAM) is increasingly administered for various conditions such as epilepsy, diabetes, migraine, autism, or cancer with beneficial outcome. There is only little evidence for nonpharmacologic treatment for children with functional constipation including CAM.What is New Variables associated with CAM use are persistence of constipation with conventional therapy (CT), occurrence of adverse events of CT, and parental CAM administration. There is a high interest for CAM in families with functional constipation of infants and children.