Constipation in children Flashcards
What is the most common cause of constipation in children?
Functional constipation - no significant underlying cause other than lifestyle factors
What classifies as constipation?
Hard stools that are difficult to pass
Less than 3 bowel motions per week
What is the presentation of constipation?
Hard stools that are difficult to pass
Less than 3 bowel motions per week
Rabbit dropping stools
Straining
Painful passage of stools
Abdominal pain
Rectal bleeding
Overflow incontinence
Loss of sensation of needing to open bowels
At what age is faecal incontinence considered pathological?
4 years
What is the medical term for faecal incontinence?
Encopresis
What are the causes of encopresis?
Chronic constipation
Hirschprung’s
Cerebral palsy
Learning disability
Psychosocial stress
Abuse
What lifestyle factors can contribute to constipation in children?
Habitually not opening the bowels
Low fibre diet
Poor fluid intake
Sedentary lifestyle
Psychosocial problems
What are the secondary causes of constipation?
Hirschsprung’s
Cystic fibrosis
Hypothyroidism
Spinal cord lesions
Intestinal obstruction
Anal stenosis
Cows milk intolerance
What are some red flags that may point to a secondary cause of constipation?
Not passing meconium within 48 hours of birth
Neurological signs in the lower limb
Vomiting
Ribbon stool
Abnormal anus
Failure to thrive
Acute severe abdominal pain and bloating
What are the complications of constipation?
Pain
Haemorrhoids
Anal fissures
Reduced sensation
Overflow and soiling
What is the first line management of constipation in children?
Movicol (+ lifestyle advice)
What type of medication is movicol?
Movicol is an osmotic laxative - they draw water into the bowel to make stool softer and easier to pass
What is faecal impaction?
A large lump of dry stool that stays stuck in the rectum?
What is the treatment of faecal impaction?
Disimpaction regimen - high doses of laxatives to clear the impaction
