Constipation Flashcards
What social problems can cause constipation?
Diet e.g. low fluid, fibre or excess milk
Potty training difficulties
What physical things could cause constipation?
Meds e.g. Gaviscon or anti-spasmodics
Intercurrent Illness
Anatomical Abnormalities
Most chronically constipated kids don’t have a physical cause, instead they get into a difficult cycle
First they get an episode of constipation
This leads to a large hard stool which causes pain or a fissure
The kid learns to withhold stool to avoid the pain which leads to further constipation etc etc
Other than not shitting, how would a chronically constipated kid present?
- poor Appetite
- Irritable
- Lacking energy
- Abdo pain/distension
- Withholding or straining
- Diarrhoea
How would we go about managing a chronically constipated child?
With diet (more fibre, fruit, veg an fluids + less milk)
Reward good behaviour with praise & star charts
Reduce adverse factors e.g. school toilets, tall toilets, punitive reactions from parents
Laxatives
What are the types of laxatives?
Osmotic e.g. Lactulose
Stimulant e.g. Senna
Isotonic e.g. Movicol
What can we do if we suspect impaction?
That’s the only time we’d do a DRE and maybe a Stool marker X-ray study
Empty the colon with laxatives
What other complication can occur from chronic constipation?
UTI due to mass of stool causing urinary stasis