Constipation and Postinfectious Gastroparesis Flashcards
Is it concerning for a breastfed infant to pass a stool less often than once every 5 days?
No. Some breastfed infants pass a stool only once every 5-10 days; in the absence of other signs or symptoms, they do not need workup or treatment.
What percentage of children with constipation have an underlying organic cause?
Constipation due to organic causes makes up only 5% of cases in childhood.
What is infant dyschezia?
It is characterized by infants straining with each stool and crying before each bowel movement. It is a normal finding in infants because they are still learning to coordinate the increase in intraabdominal pressure with the simultaneous relaxation of the pelvic floor.
What is the treatment for infant dyschezia?
No treatment is required since this is a normal developmental finding. Provide reassurance to parents.
What is the most common cause of constipation in children?
Functional constipation
What is the most common cause of encoparesis in children?
Functional constipation
What is functional constipation?
It is the voluntary withholding of stool due to the fear of defecation.
At what two ages is functional constipation most common?
It is most common at the time of toilet training and when the child starts school.
What physical exam findings suggest spinal dysraphism as a potential cause of constipation?
A deep sacral pit, or a vascular or hairy patch on the sacrum.
What imaging studies should be performed in patients suspected of having spinal dysraphism as the source of their constipation?
Consider lumbosacral ultrasound or MRI.
How is functional constipation treated?
It is treated with a mixed behavioral and medical approach, including positive reinforcement schedules and the use of stool softeners.
When is it safe to discontinue stool softening agents in patients with functional constipation?
Stool softening agents may be discontinued after at least 6 months of pain free and accident-free success.
What is postinfectious gastroparesis?
Delayed gastric emptying which occurs after a viral gastroenteritis. The mechanism seems to be due to the infecting agent causing a neuropathy of the autonomic ganglia either directly or indirectly via an inflammatory response.
What is the gold standard for diagnosis if postinfectious gastroparesis?
Gastric acid scintigraphy, which consists of measuring the rate of gastric emptying of a radiolabeled meal over a defined period of time.
What is the natural course of postinfectious gastroparesis?
It is self-limited and usually resolves within 1-3 months, although it can last up to 24 months.
