Constipation in Children Disease Summary

Overview

Constipation is defined as a delay or difficulty in bowel movement persisting for more than 2 weeks causing significant distress. It is a common digestive problem, but not a disease and usually not serious as stated in the Introduction section. While further discussion on the prevalence of constipation in children is in the Epidemiology section.

In the Pathophysiology section, the usual start of constipation in children and the effects of it are discussed.

Factors that can contribute and lead to the development of constipation in children are enumerated in the Risk Factor section.

The Classification section differentiates the different types of constipation. 

Constipation in Children_Disease Summary

History and Physical Examination

Signs and symptoms of constipation in children are enumerated in the Clinical Presentation section. Some of which are absence of bowel movement and irregular stool texture.

The History section enumerates the key components of history taking in children suspected of having constipation. While the Physical Examination section enumerates the focus of assessment during the examination. 

Diagnosis

The Diagnosis or Diagnostic Criteria section features the Rome IV diagnostic criteria of functional constipation in different age groups of children.

Laboratory studies are generally not necessary unless an organic disease is suspected from history and physical examination and the child is unresponsive to adequate treatment. The Laboratory Tests and Ancillaries and Imaging sections enumerate these tests.

The Differential Diagnosis section discusses Hirschsprung disease and spinal cord abnormalities that may or may not be associated in children with constipation.

Management

In the Evaluation section, red flags (eg abnormal appearance of anus, gross abdominal distention) indicative of organic constipation is enumerated.

As discussed in the Principles of Therapy section, a normal fiber and fluid intake, and normal physical activity, in combination with education and demystification, is the recommended initial treatment strategy for functional constipation. Other treatment strategies and indications for specialist referral are also discussed.

Oral disimpaction is the preferred management strategy for pediatric constipation. The Pharmacological Therapy section enumerates initial and maintenance therapies for disimpaction.

Parental education and behavioral and dietary modifications are discussed in the Nonpharmacological section.

Surgical procedures may also be considered in children with constipation, and they are enumerated in the Surgery section.

The child’s treatment response assessment tests are mentioned in the Monitoring section. While the Prognosis section discusses the possible outcomes of treatment of children with constipation.