Constipation in Children

Question 1

1st stools in baby called what?

Answer 1

meconium

Question 2

meconium colour

Answer 2

dark green colour

Question 3

how does Neonate stool frequency change with time normally?

Answer 3

passes lots of stool to begin with, decreases with time

Question 4

Infants pass how many stools a day?

Answer 4

3 x day

Question 5

this gradually decreases to how many stools a day in toddlers?

Answer 5

1xday

Question 6

Most kids with constipation the cause if what using surgical sieve?

Answer 6

idiopathic

Question 7

causes of constipation in children?

-5

Answer 7

dehydration
low fibre diet
medications (e.g. Opiates)
hypothyroidism
Hirschsprung’s disease.

Question 8

Red Flags for baby or child with constipation?

-6

Answer 8

starts from birth

no meconium until after 48 hrs

child not growing

any motor delay (weakness in legs for e.g.),

abdomen is distended

ribbon stools

Question 9

ribbon stools are a sign of what?

Answer 9

anal stenosis

Question 10

easy way mum prevent constipation in baby?

Answer 10

Breastfeed

Question 11

Complication of constipation in child?

-1

Answer 11

faecal impaction

Question 12

main symptoms of faecal impaction?

-2

Answer 12

overflow soiling

abdo pin

Question 13

sign on examination of faecal impaction?

-1

Answer 13

feel stool mass in abdomen

Question 14

describe overflow soiling

Answer 14

very loose stools, you pass without realising

Question 15

what is causing this overflow soiling?

Answer 15

liquid stool goes around the impaction

Question 16

Treatment for faecal impaction lasts how long?

Answer 16

3 months

Question 17

1st line drug given for faecal impaction?

Answer 17

Movicol paediatric plain

Question 18

what is Movicol paediatric plain?

Answer 18

polyethylene glycol 3350 + electrolytes

Question 19

what is polyethylene glycol?

Answer 19

osmotic laxative

Question 20

how long do you wait to check if movicol paediatric plain is working?

Answer 20

2 weeks

Question 21

if movicol paediatric plain not working after 2 weeks,
what is 2nd line drug group?

2 named examples in this group?

Answer 21

stimulant laxative

senna or sodium picosulphate

Question 22

what should you tell parents when starting child on movicol paediatric plain?

Answer 22

abdo pain and soiling will increase initially

Question 23

what non-pharmacotherapy/lifestyle type things can parents do to help child with faecal impaction?
-3

Answer 23

drink water
high fibre diet
infant - rub their tummy

Question 24

Maintenance Therapy for faecal impaction:

1st line drug?

Answer 24

Movicol paediatric plain

Question 25

Maintenance Therapy for faecal impaction:

2nd line drug if no response?

Answer 25

add stimulant laxative

Question 26

Maintenance Therapy for faecal impaction:

3rd line drug if still no response?

Answer 26

add lactulose

Question 27

lactulose drug group?

Answer 27

osmotic laxative

Question 28

how do osmotic laxative help constipation?

Answer 28

draw water into stool softening it

Question 29

why does movicol paediatric plain include electrolytes?

Answer 29

because long term use of laxative can cause

electrolyte imbalance