constipation%20in%20children
CONSTIPATION IN CHILDREN

Constipation is a delay or difficulty in bowel movement persisting for ≥2 weeks.
It is a common digestive problem, not a disease, and usually not serious caused by changes in diet and early toilet training.
Constipation in children generally first happens in the toddler stage, between ages 2 and 4 years, with studies showing variation in gender-specific prevalence.
Functional constipation is  the one that cannot be explained by any anatomical, physiological, radiological or histological abnormalities.
Organic constipation is with identifiable physiological or organic cause.
Chronic constipation is the constipation that lasts for >8 weeks.

Introduction

  • A delay or difficulty in bowel movement persisting for ≥2 weeks
  • A common digestive problem, not a disease, & usually not serious
  • Constipation in children generally first happens in the toddler stage, between ages 2 & 4 years, with studies showing variation in gender-specific prevalence

Etiology

  • Factors that may cause constipation:
    • Pain
    • Dehydration
    • Psychological issues (eg depression, attention-deficit disorder, sexual abuse)
    • Toilet training
    • Fever
    • Dietary & fluid intake
    • Cow’s milk protein allergy
    • Medicines (eg opioids, antidepressants, anticholinergics)
    • Family history of constipation
    • Withholding that may result from ignoring the urge to defecate due to toilet phobia, being too busy, toilet unavailability, & pain from bowel movement
    • Changes in routine (eg travel, stress, hot weather)
    • Medical conditions (eg intestinal, rectal or anal, metabolic or endocrine diseases)

Signs and Symptoms

  • Absence of bowel movement for several days (may be normal in breastfed infants)
  • Encopresis - soiling of undergarments due to the involuntary leakage of feces
  • Large, hard, & dry stools or frequent small pellets
  • Irregular stool texture
  • Foul smelling wind & stools
  • Blood in stool
  • Pain while defecating
  • Excessive flatulence
  • Withholding or straining to stop passage of stools
  • Abdominal pain
  • Distension or discomfort
  • Poor appetite
  • Crankiness or unhappy, irritable mood
  • Lack of energy
  • Body malaise
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