Description
Children frequently have functional constipation (FC), which is a common issue with a 3% global prevalence estimate. If there is no underlying organic cause for constipation, which is the case with up to 95% of children, it is classified as FC. It can be seen in healthy children one year of age and older, but it is more prevalent in preschoolers. Although the frequency varies from person to person, most people have regular bowel movements. Stools should go through without any discomfort or exertion. Functional constipation is frequently characterized by painful defecation, hard stools passing through the digestive tract, infrequent or difficult bowel movements, and/or a sense of incomplete stoma evacuation. It frequently isn't brought on by any underlying systemic issue or anatomical flaw.
Summary Listen
- Functional constipation in children is a common yet often underdiagnosed condition, affecting 5-30% of the child population. It is crucial to differentiate it from other medical conditions presenting similar symptoms. Red flag signs, such as constipation from birth, failure to pass meconium, ribbon stools, and lower spine abnormalities, must be ruled out before diagnosing functional constipation.
- Functional constipation often begins during significant developmental periods: weaning from breast milk to solid food, toilet training, starting school, or after a viral illness. These events can lead to anxiety or avoidance behaviors that contribute to constipation. A thorough history, including stool consistency, frequency, painful defecation, diet, and behavioral problems, is essential.
- Treatment consists of two phases: disimpaction and maintenance. Disimpaction involves removing accumulated fecal matter, often using polyethylene glycol (PEG) at doses of 1-2 g/kg. Maintenance focuses on regular toilet training, adequate fluid intake, physical activity, and behavioral modifications.
- Parents' understanding and acceptance of the diagnosis are crucial for successful treatment. Healthcare providers should counsel families on diet modifications, medication usage, and the chronic nature of the condition. Regular follow-up is necessary to monitor progress and adjust the treatment plan.
- Addressing the constipation can resolve related issues like abdominal pain, bedwetting, and behavioral problems. Healthcare providers should encourage open communication, provide education about constipation, and support lifestyle modifications to improve outcomes.
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