Chronic constipation in infants and children.

Singapore Medical Journal
Jeremy Meng Dao Ho, Choon How How

Abstract

Constipation is common in infants and children. Helping parents understand the vicious cycle of childhood chronic constipation is the key to successful management. Weaning, toilet training, transitions to kindergarten/school, a bout of febrile illness and overseas holidays are common life milestones that may be associated with an increased risk of constipation. A detailed history and targeted physical examination can rule out most organic causes of chronic constipation. Infrequent defecation (≤ 2 per week), faecal incontinence, retentive posturing, painful or hard bowel movements or large diameter of stool suggest functional constipation. The Bristol stool chart is a free, useful tool for parents or caregivers to report and monitor the child's stools. Red flags in constipation include delayed passage of meconium beyond 48 hours of life, associated intestinal obstruction symptoms, developmental delays, behavioural problems and frequent soiling of underwear. Behavioural modifications should be considered in primary care, together with pharmacotherapy such as laxatives.

References

Sep 23, 1997·Scandinavian Journal of Gastroenterology·S J Lewis, K W Heaton
Mar 10, 2005·The Journal of Pediatrics·Vera Loening-Baucke
Oct 13, 2006·The American Journal of Gastroenterology·Maartje M van den BergC Di Lorenzo
Apr 30, 2013·Singapore Medical Journal·Fang Kuan ChiouChristina Ong
Jul 30, 2014·Birth Defects Research. Part A, Clinical and Molecular Teratology·Kate E BestJudith Rankin
May 5, 2016·Gastroenterology·Jeffrey S HyamsMiranda van Tilburg

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