Constipation

Question 1

Criteria used for functional constipation?

Answer 1

Rome IV criteria

Question 2

Rome IV criteria components

Answer 2

2 or fewer defections per week, at least 1 episode of faecal incontinence per week, large diameter stools, painful hard bowel movements

Question 3

Organic causes if constipation

Answer 3

Allergy - cow’s milk protein, coeliac disease, hypothyroidism, CF, hypercalcaemia, hyperkalaemia, drugs - opiates

Question 4

Red flags for constipation

Answer 4

Blood in stools, faltering growth, weight loss, lethargy, perianal disease, IBD symptoms, delayed passage of meconium after the first 48 hrs of life, ribbon like stools, urinary symptoms, abnormal lower limb neurology, imperforate anus

Question 5

Physical examination of constipation

Answer 5

Red flags, abdominal exam - faecal masses, inspect the anus (patency, fissures, patulous anus (loose, open associated with prolapse), anteriorly placed anus)

Question 6

Investigations for constipation

Answer 6

Not normally recommended - if required IgA, tTG, TFT, calcium and electrolytes

Question 7

Disimpaction treatment regime

Answer 7

1-1.5g/kg/day of polyethylene glycol (PEG) (movicol) for 3 days

Question 8

Maintenance treatment regime

Answer 8

PEG 0.75g/kg/day