Pediatria pre prax 2/2009

Constipation in children, prevention and treatment

Constipation is one of the most common clinical problems encountered by paediatricians and gastroenterologists. It is important to diffe rentiate between the differential diagnoses that include organic as well as functional aetiologies. The main pathophysiological mechanism in functional constipation is pain of, and the acutal pain encoutered during defecation. The clinical picture is dominated by infrequent and difficult bowel emptying with large amounts of thickened stool. As long as there is an absence of signs and symptoms, as well as a positive exclusion of a functional cause, therapeutic intervention may be warranted. A complex therapeutic strategy includes eduction of parents and the whole family, active removal of retented stool and initiating changes in the diet entailing increased fluids and fibre. Essential to success also includes increased physical activity, defecation training and the use of osmotic laxatives.

Keywords: chronic constipation, children, treatment, prevention.