CHARACTERISTICS OF CHILDREN UNDER 5 REFERRED TO HOSPITAL WITH CONSTIPATION - A ONE-YEAR PROSPECTIVE-STUDY

Constipation in the pre-school child can cause considerable distress t o the individual and to the family. Most cases are idiopathic and with early diagnosis and effective treatment prognosis is good. In a teach ing hospital paediatric unit, a year-long prospective study identified 42 new referrals for constipation in children under 5. Before referra l for a specialist opinion there appeared to be considerable variation in both duration of symptoms and treatment given. Psychological facto rs in the family, as well as advice regarding simple behaviour modific ation and management of common secondary behavioural problems, seemed largely overlooked. Guidelines for treating constipation in the commun ity could help standardise and improve care. For children with refract ory constipation referred to a specialist centre, we recommend a multi disciplinary assessment including paediatrician, paediatric surgeon, a nd member of the child mental health team.