Abstract: Functional constipation（FC）is one of the most common pediatric lower gastrointestinal disorders of gut-brain interaction（DGBI）.The RomeⅤcriteria reorganize pediatric lower gastrointestinal and biliary DGBI from an age-based framework toward a classification based on anatomical regions and symptom patterns. Under this framework，FC，functional nonretentive fecal incontinence（FNRFI），and infant dyschezia are addressed as defecation/anorectal disorders，while pediatric developmental context，toilet training，and caregiver-reported symptoms remain essential. Based on the RomeⅤlower and biliary child/adolescent article，the Rome Ⅴdiagnostic questionnaire article，corresponding Rome Ⅳ documents，and recent English-language guidelines and studies，this review summarizes the epidemiology，pathophysiology，diagnostic criteria，clinical evaluation，stepwise treatment， and refractory constipation management of pediatric FC. FNRFI and infant dyschezia are discussed as special-focus differential diagnoses. The goal is to support positive diagnosis，careful identification of alarm features，evidence-based treatment，and multidisciplinary care when needed.

Key words: functional constipation, functional nonretentive fecal incontinence, infant dyschezia, disorders of gut-brain interaction, Rome V, children, polyethylene glycol

摘要：  儿童功能性便秘（functional constipation，FC）是儿科下消化道肠- 脑互动异常（disorders of gut-brain interaction，DGBI）中最常见的疾病之一。罗马Ⅴ标准将儿童下消化道及胆道DGBI 由既往年龄分层框架调整为以解剖区域和症状模式为基础的分类。文章以罗马Ⅴ诊断问卷文献、罗马Ⅳ对标文献以及近年欧洲儿科胃肠病学、肝病学和营养学会及北美儿科胃肠病学、肝病学和营养学会等指南为依据，重新梳理了儿童FC 的流行病学、发病机制、诊断标准、临床评估、阶梯化治疗和难治性便秘管理，并将非潴留性大便失禁和婴儿排便困难作为特别关注项目进行鉴别说明。新版框架提示，临床诊疗应从单纯关注排便频率转向综合评估症状模式、粪便性状、排便疼痛、忍便行为、功能受损、发育背景、家庭心理社会因素和报警征象，以实现积极诊断、规范治疗和长期管理。

关键词: 功能性便秘, 非潴留性大便失禁, 婴儿排便困难, 肠- 脑互动障碍, 罗马Ⅴ, 儿童, 聚乙二醇