- 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
- Abdominal pain or bloating
- Functional constipation (voluntary withholding)
- Diet high in dairy products or low in fiber
- 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
- 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
- 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
- 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
- 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.