Constipation and GI diagnoses in children with solid tumours: prevalence and management

Sep 21, 2026

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Constipation and gastrointestinal (GI) diagnoses affect children with cancer during chemotherapy, yet real-world inpatient burden and treatment patterns remain unclear. This study retrospectively analyzed Pediatric Health Information System data from children aged 0–21 years with solid tumours hospitalized between October 2015 and December 2019, identifying constipation as the most frequent GI complaint. Among 13,375 chemotherapy-treated patients, 64.7% met criteria for constipation, with opioid exposure and varied laxative use. Findings support constipation-focused prophylaxis and risk-tailored management.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Objectives

Methods

Results

Conclusions

Introduction

Background and rationale

What this study adds

Original research Constipation and GI diagnoses in children with solid tumours: prevalence and management Jennifer Belsky , 1,2 Joseph Stanek,3 Nicholas Yeager,3 Daniel Runco 1,2 ► Additional supplemental material is published online only. To view, please visit the journal online ([http://dx.doi](http://dx.doi). org/10.1136/spcare-2021- 003506) . 1Pediatric Hematology/Oncology/ BMT, Riley Hospital for Children, Indianapolis, Indiana, USA 2Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA 3Nationwide Children’s Hospital, Columbus, Ohio, USA Correspondence to Dr Jennifer Belsky, Riley Hospital for Children, Indianapolis, Indiana, USA; [jbelsky@iu.edu](jbelsky@iu.edu) Received 14 December 2021 Accepted 12 August 2022 Published Online First 30 August 2022 © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. To cite: Belsky J, Stanek J, Yeager N, et al. BMJ Supportive & Palliative Care 2023;13:e1166–e1173 . ABSTRACT Objectives Despite continued development of targeted therapies for children with cancer, patients continue to experience an array of unwanted side effects. Children with solid tumours may experience constipation as a result of vinca alkaloid therapy, psychological stressors, periods of inactivity and opioid use. Our objective was to investigate the prevalence and treatment of constipation in hospitalised children with solid tumours treated with chemotherapy. Methods We retrospectively analysed data from 48 children’s hospitals in the Pediatric Health Information System, extracting patients 0–21 years of age with a solid tumour diagnosis hospitalised from October 2015 through December 2019. Results We identified 13 375 unique patients with a solid tumour diagnosis receiving chemotherapy. Constipation was the most common gastrointestinal complaint with 8658 (64 . 7%; 95% Cl: 63.9% to 65. 5%) having a constipation diagnosis or having received at least two laxatives during admission. Bone cancers had the highest percentage (69 .9%) of patients with constipation, while Hodgkin’s lymphoma had the lowest, although 52. 1% of patients were affected. A total of 44%(n=35 301) of encounters received an opioid at some point during admission. Of patients receiving constipation medications, the most commonly prescribed was polyethyl glycol (n=25 175, 31. 7%), followed by docusate (n=11 297, 14.2%), senna (n=10 325, 13.0%) and lactulose (n=5501, 6.9%) . Conclusions Constipation is the most common gastrointestinal issue that children with solid tumours experience while receiving chemotherapy in the inpatient setting. Increased attention should be given to constipation prophylaxis and treatment in children with solid tumours undergoing chemotherapy, particularly those identified as high risk. WHAT IS ALREADY KNOWN ON THIS TOPIC | ⇒ Constipation in the paediatric population is common.
⇒ Constipation in oncology is multifactorial.
WHAT THIS STUDY ADDS | | --- | | ⇒ Children with solid tumours receiving chemotherapy suffer from constipation.
⇒ There is no standard-of-care constipation treatment in paediatric oncology.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY | ⇒ Attention to populations most at risk would result in proactive constipation management leading to increased survival. ⇒ Clinical practice guidelines for constipation supportive care are missing in paediatric oncology. INTRODUCTION Childhood cancer remains the second leading cause of death in children aged 5 to 14 years.1 The most common diagnoses in the USA include leukaemias, central nervous system (CNS) tumoursand lymphomas along with a variety of other solid tumors.2 Children with cancer undergoing treatment suffer a litany of unwanted side effects during and after their therapy. While survival rates continue to improve with the incorporation of immunotherapy and targeted therapy, many CNS and non

FAQs

What is the main purpose of this study?

To investigate how common constipation is and how it is treated in hospitalized children with solid tumours receiving chemotherapy.

How was the data collected and which patients were included?

The study retrospectively analyzed Pediatric Health Information System data for patients aged 0–21 years with solid tumour diagnoses hospitalized from October 2015 through December 2019.

What treatments were most commonly used for constipation?

Among patients receiving constipation medications, the most commonly prescribed were polyethyl glycol, followed by docusate, senna, and lactulose.

Sep 21, 2026

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