File Name: evaluation and treatment of constipation in infants and children .zip
- Constipation in Children
- Evaluation and Management of Pediatric Constipation
- Paediatric constipation: An approach and evidence-based treatment regimen
Constipation in Children
It is defined as delay or difficulty in defecation. Normal frequency and consistency of stool varies with children's age, and diet; there is also considerable variation from child to child. In general, signs of effort eg, straining in a young infant do not signify constipation. Infants only gradually develop the muscles to assist a bowel movement. Hirschsprung disease.
More-extensive testing is usually reserved for only the most severe cases of constipation. If necessary, these tests may include:. Over-the-counter fiber supplements or stool softeners. If your child doesn't get a lot of fiber in his or her diet, adding an over-the-counter fiber supplement, such as Metamucil or Citrucel, might help. However, your child needs to drink at least 32 ounces about 1 liter of water daily for these products to work well.
Evaluation and Management of Pediatric Constipation
In the absence of organic aetiology, childhood constipation is almost always functional and often due to painful bowel movements that prompt the child to withhold stool. It is important to initiate a clear management plan for the family, as what is an easily treatable condition can escalate into a vicious cycle of pain if not addressed early. The medical approach should consider organic disease, the use of appropriate toileting habits, and dietary modifications. Laxatives are often required to re-establish regular, painless defaecation. Articles in this series aim to provide information about diagnosis and management of presentations in infants, toddlers and pre-school children in general practice. Within the first three months of life, infants can pass anywhere from 5 to 40 motions per week, decreasing at age one year to 4—20 motions per week and at three years to 3—14 per week. Constipation under these criteria requires two or more of the following: 3.
Constipation is a common problem in children. It is common in both rich and poor countries despite the belief that developing countries consume food rich in fiber. Normal bowel movement in breastfed babies may range from several times a day to once in every 10 days. Constipation can be both functional and pathological. Functional constipation has no underlying cause and is the most common type of constipation found in children. My main focus will be on this common type of constipation. In functional constipation routine, digital rectal examination is not recommended unless impaction is suspected.
To assist medical care providers in the evaluation and management of children with functional constipation, the North American Society for Pediatric Gastro-.
Paediatric constipation: An approach and evidence-based treatment regimen
Constipation is one of the most common problems evaluated by pediatricians, pediatric gastroenterologist, and pediatric surgeons alike. A clear and concise management algorithm is needed to appropriately treat patients and avoid unnecessary outpatient and emergency department visits. Once organic causes of constipation have been ruled out, treatment should progress in a stepwise fashion until success, defined as daily bowel movements without encopresis or overflow pseudoincontinence. Therapy should begin with diet modification and progress through the use of polyethylene glycol, stimulant laxatives, daily enemas, and even formal inpatient fecal disimpaction.
Investigations are not routinely required. If constipation persists despite adequate behaviour modification and laxative therapy, consider investigating for less common conditions as listed above. First line treatment options oral laxatives. Anal fissures can be treated with topical Petroleum Jelly to provide pain relief. The number of sachets or scoops to be taken daily for disimpaction are listed below.
Many factors contribute to the large variation in the reported prevalence of constipation in children. The different criteria used for the definition of functional constipation in studies hinders the comparison between prevalence estimates. The pathophysiology of functional constipation in children remains unclear, but is multifactorial. Recently, the new Rome IV criteria have been released. In young children, it often starts after a painful-frightening bowel movement, while in older children it is due to the very active lifestyle and school system, were children do not have enough time for a proper bowel movement.