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Constipation

more about Constipation


  • Constipation describes a change in a child's bowel habits, such that the stool amount is decreased, hard, decreased in frequency, or there is excessive straining during defecation.
  • A nursing infant may have normally infrequent stools.
  • Constipation can be classified as functional constipation, in which there is no organic abnormality, and organic constipation, in which there is organic abnormality.

  • Hard, small stools passed with difficulty
  • Irritability
  • Abdominal pain or bloating

  • Functional constipation (voluntary withholding)
  • Diet high in dairy products or low in fiber
  • Starvation
  • Resistance to toilet training
  • Irritation or fissure of the anus
  • Organic constipation: Intestinal abnormalities such as Hirschsprung's disease, anal-rectal stenosis, stricture
  • Drugs such as narcotic pain medications, antidepressants, anticonvulsants, iron supplements, calcium channel blockers, antacids
  • Metabolic disorders such as Dehydration, Cystic Fibrosis, Hypothyroidism, hypokalemia, renal tubular acidosis, hypercalcemia
  • Neuromuscular disorders such as myotonic dystrophy, spinal cord lesions, amyotronia congenita
  • Decreased mobility
  • Colonic lesions, e.g., colon cancer
  • Previous radiation treatment to the area

  • Based on historical information
  • Presence of hard stool palpable in the lower abdomen or in the rectum.
  • Blood test, stool test, a barium enema colonoscopy for underlying disease

  • Enema
  • Discourage child from eating junk food
  • Stool softeners
  • Encourage child to develop a regular toilet habit
  • Appropriate management for underlying disease
  • Eat supplementary bran, either in cereal or flakes supplemented to food
  • Prune juice or prunes
  • Psyllium fiber -- whole husk-type found in health food stores is more effective than processed forms (Metamucil), but either may be tried.  Take with complementary amount of liquid.
  • Stool softeners, e.g. doculasate sodium (Colace) are helpful
  • Senekot is a natural stimulant laxative
  • Lactulose by prescription
  • Magnesium Citrate for severe constipation (should not be taken by those with kidney disease)
  • Polyethylene glycol solution (GOLYTELY) for severe constipation
  • Mineral oil
  • Fecal impaction -- occurs when constipation is so severe that the entire rectum fills with a hard ball of stool.  In this case, medications usually do not work, and manual disimpaction is needed (medical personnel remove the blockage manually).

  • Special consideration:

- All cases of persistent constipation, even in younger individuals, should be evaluated by a physician.  Though rare, rectal and colon cancer does occur in patients below 35 years of age.






more about Constipation


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