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Education key in tackling childhood constipation
Nick Nelhans1, Rebecca Williams
1Department of Paediatrics, Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board.
The Practitioner
|September 4, 2010
Summary
Childhood constipation is common and often leads to chronic issues. Effective management relies on diagnosing idiopathic constipation through a detailed history to break the cycle of painful defecation.
Area of Science:
- Pediatric Gastroenterology
- Child Health
Background:
- Constipation is a prevalent pediatric gastroenterological issue, impacting 5-30% of children.
- Chronic constipation affects up to one-third of affected children, often with unclear underlying causes.
- Delayed help-seeking is common due to unclear symptoms.
Purpose of the Study:
- To highlight the importance of diagnosing idiopathic constipation in children.
- To emphasize the link between constipation and other pediatric conditions.
- To guide effective management strategies for childhood constipation.
Main Methods:
- Diagnosis of idiopathic constipation is primarily established through thorough patient history.
- Assessment for fecal impaction is crucial for determining therapeutic steps.
- Clinical examination aids in diagnosing fecal impaction.
Main Results:
- A significant percentage of children with daytime urinary incontinence (up to 29%) and bedwetting (34% in those over five) have chronic constipation.
- Chronic constipation is a risk factor for recurrent urinary tract infections (UTIs) in children.
- Urinary retention and vulvovaginitis are associated with chronic constipation.
Conclusions:
- Accurate diagnosis of idiopathic constipation through history taking is key to effective management.
- Educating families that symptoms have a medical basis is important.
- Identifying and managing fecal impaction is a critical next step after diagnosis.
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