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Gastroenterology clinic

Constipation in infants and children

LUCINDA MARKS, Scott Nightingale
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© ann in the uk/shutterstock
© ann in the uk/shutterstock

Abstract

Constipation is a common problem in childhood and is usually functional, often involving stool withholding. Successful management requires parent education, behavioural strategies, laxatives (often long term) and ongoing review.

Article Extract

Remember

  • Constipation affects up to 30% of children, and peak incidence is at the time of toilet training.1-3

  • Constipation is defined by the frequency of stooling (fewer than two per week in children over 4 years of age), but more importantly by stool consistency and difficulty with which stools are passed (Case Study 1, Box 1).

  • Constipation arising beyond the neonatal period is usually functional constipation; this diagnosis can be made clinically after a careful history and physical examination, looking for red flags that may suggest organic pathology.

  • Faecal incontinence (encopresis) develops in up to 50% of children with chronic untreated constipation and has a significant psychosocial impact.4

  • Management of constipation is often a long-term process that requires the complementary approaches of careful education of the child and parents, behavioural techniques, laxative agents and review.

Figures

© ann in the uk/shutterstock
© ann in the uk/shutterstock