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Constipation in childhood: a multidisciplinary approach to management in the community
Nermeen Galal1, Sonny K F Chong, Julie Williams
1Queen Mary's Hospital.
Insights
Chronic constipation affects 3% of children. Management involves identifying causes through examination, treating fecal impaction first, and implementing lifestyle changes like increased fiber, fluids, and regular toileting habits.
Area of Science:
- Pediatrics
- Gastroenterology
Background:
- Chronic constipation is a common pediatric issue, potentially affecting 3% of children.
- Causes can be organic or functional, necessitating a comprehensive diagnostic approach.
Purpose of the Study:
- To outline the management strategies for chronic constipation in children.
- To emphasize the importance of accurate diagnosis and phased treatment.
Main Methods:
- Thorough patient interview and physical examination to identify causes.
- Initial management focuses on resolving fecal impaction with appropriate medications.
- Additional strategies include dietary modifications (fiber, fluids) and behavioral interventions (toileting programs).
Main Results:
- Effective management requires addressing fecal impaction as the primary step.
- Lifestyle adjustments and structured toileting programs are crucial for long-term success and continence.
Conclusions:
- A systematic approach combining medical, dietary, and behavioral interventions is key to managing pediatric chronic constipation.
- Early identification of causes and prompt treatment of impaction lead to improved outcomes.
Abstract:
Three per cent of children in the community may be affected by chronic constipation. Causes of constipation may be organic or functional: the cornerstone of management is thorough interview and physical examination to identify appropriate investigations, identify causes and decide on management. Whatever the cause, faecal impaction must be managed as the first phase of treatment using appropriate medications. Other strategies may include increasing the fibre content of the child's meals and increasing fluid intake. Getting into a regular toilet habit helps prevent constipation and a structured toileting programme promotes the resumption of faecal continence.
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