Management of chronic constipation in children

Constipation is a common symptom of various pathologies with dysfunction of the intestinal motricity which largely differ in their expression and seve rity. However chronic idiopathic constipation is by far the most frequent c ondition. Only constipations associated with symptoms such as poor nutritio nal status, failure to thrive, signs of upper intestinal tract obstruction (gross abdominal distention), or showing resistance to the usual therapeuti c approach, justify investigations looking for an organic disease, mainly H irschsprung disease. Treatment of chronic idiopathic constipation requires, first to evacuate the fecal mass, then to prevent its reconstitution mainl y by dietetic measures, regular large hydration, stool modifying therapy da ily bowel habit, and regular physical activities; in addition it is importa nt that clear and reassuring explanations be given to the parents. (C) 1999 Editions scientifiques et medicales Elsevier SAS.