Background: Primary vesiculoureteral reflux (VUR) is the most common pediatric urologic abnormality. Severity is graded I (mildest) to V (most severe). Increasing severity, bilaterality, and presence of dysfunctional elimination syndrome, particularly constipation, decrease the likelihood of spontaneous resolution.
Objective: Describe the clinical presentation, treatment, and response of a 31-month-old female patient previously diagnosed withgrade I right-sided VUR and grade IV left-sided VUR and chronic constipation to application of chiropractic manipulative therapy (CMT), abdominal massage, and probiotic supplementation.
Clinical Features: The patient was originally diagnosed at seven months with bilateral grade V VUR after hospitalization for Escherichia coli septicemia. She presented to a chiropractic clinic four days after her most recent visit to a pediatric urologist, who reiterated that her chronic constipation was the most negative prognostic factor for future non-surgical improvement in her grade IV left VUR.
Intervention and outcome: This patient was treated via instrument adjusting and manual CMT, abdominal massage, and probiotic supplementation over ten visits. During care, the child’s frequency of evacuation increased, her pain and fear of evacuation decreased, and stool consistency normalized.
Conclusion: Chronic constipation in a pediatric patient with VUR improved after initiation of a CAM care plan.
Author affiliations: VAB, TAW: Associate Professor, Palmer College; JMC: Private Practice, Newburgh, NY
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