CONSTIPATION IN CHILDREN

Constipation is a common childhood condition, estimated to occur in 5 to 10 percent of children. In most cases, the cause is functional. How ever, constipation may occasionally indicate a significant organic dis order, which can usually be determined by a thorough history and physi cal examination. Constipation that is present from birth or that begin s in the neonatal period is most likely to be congenital in origin. Ac ute constipation usually has an organic cause, while chronic constipat ion usually has a functional cause. Failure to thrive and gross disten tion of the abdomen suggest the diagnosis of Hirschsprung's disease. R ectal examination of a child with constipation usually reveals a diste nded rectum that is full of stool. In patients with Hirschsprung's dis ease, the rectum is usually empty and tight. Laboratory investigations are usually not necessary in patients with mild constipation. Treatme nt should be directed at the underlying cause. Functional constipation can be managed by changes in diet, regular bowel habits and, if neces sary, pharmacologic therapy and biofeedback training.