Constipation in children - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Childhood constipation is typically characterized by infrequent bowel evacuations, large stools, and difficult or painful defecation.
Symptoms often result from low fiber, poor nutrient, poor stooling technique, and/or insufficient water intake, which leads to excessive hardening of the stool. This often starts as an acute problem but can progress to fecal impaction and chronic constipation.
Particularly in young children, any cause of painful defecation may provoke active withholding. Withholding may worsen the constipation and lead to a vicious cycle.
Duration of constipation and amount of stool burden may depend on capacity of the child's rectum, the degree of rectal dilation (if excessive, often called megarectum), and other factors including rectal sensory function.
After fecal disimpaction, maintenance stool softeners are essential and are often required for many months or years to reduce relapse risk.

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Bristol stool chart

Citations

Key Articles

Rubin G, Dale A. Chronic constipation in children. BMJ. 2006 Nov 18;333(7577):1051-5.[Abstract][Full Text]
Mulhem E, Khondoker F, Kandiah S. Constipation in children and adolescents: evaluation and treatment. Am Fam Physician. 2022 May 1;105(5):469-78.[Abstract]
Benninga MA, Faure C, Hyman PE, et al. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology. 2016 Feb 15 [Epub ahead of print].[Abstract]
Hyams JS, Di Lorenzo C, Saps M, et al. Functional disorders: children and adolescents. Gastroenterology. 2016 Feb 15 [Epub ahead of print].[Abstract]
National Institute for Health and Care Excellence. Constipation in children and young people: diagnosis and management. Jul 2017 [internet publication].[Full Text]

Referenced Articles

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