Функциональный запор у детей: мультидисциплинарный подход в эпоху Rome V

Функциональный запор у детей раннего возраста остается одной из наиболее распространенных причин обращения за медицинской помощью в педиатрической практике. Поиск литературных источников проводился в электронных базах данных PubMed/MEDLINE, eLIBRARY.RU, Cochrane Library, Google Scholar за период с 1961 по 2026 г. Оценены более 100 публикаций, из них включены в обзор 57 источников литературы. Современные представления, отраженные в критериях Rome V 2026 г., рассматривают данное состояние не как изолированное нарушение моторики кишечника, а как многофакторное расстройство взаимодействия между кишечником и мозгом, формирующееся под влиянием генетических, микробиологических, нейромоторных, поведенческих и психосоциальных факторов. Такой подход существенно расширяет понимание патогенеза заболевания и требует комплексной оценки состояния ребенка. Особое значение в развитии функционального запора имеют ранние этапы постнатального развития, когда происходит становление кишечной микробиоты, моторной функции желудочно-кишечного тракта и механизмов нейроиммунной регуляции. Нарушение этих процессов может способствовать формированию хронического течения заболевания, развитию ретенционного поведения, мегаректума, энкопреза, а также оказывать негативное влияние на физическое, эмоциональное и социальное благополучие ребенка. В этой связи своевременная диагностика, основанная на выявлении клинических критериев Rome V и исключении «красных флагов» органической патологии, является ключевым условием успешного ведения пациентов. Важнейшими компонентами терапии остаются обучение родителей, устранение факторов, поддерживающих порочный круг запора, сохранение грудного вскармливания, рациональная диетологическая коррекция, применение современных безопасных осмотических слабительных средств и поддержание нормального микробного баланса кишечника в соответствии с действующими международными рекомендациями.

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