Constipation: Constipation is a common problem in children, means passing hard stools (feces), with difficulty, and less often than normal. When it lasts for >4 weeks, it is known as “significant constipation”. It is important that constipation should be recognized early to prevent it from becoming a long-term problem.
What causes this problem and how common is it?
In routine pediatric practice, ~10% of children present with constipation. It is noted in the 1st year of life in 17–40% of cases; 95% cases of constipation
are functional and only 5% are due to organic reasons.
CAUSES
Changes in routine—timing of defecation, nonavailability of toilets (during travel), etc.
Dietary factors: Predominant milk-based diet, bottle-feeding, diet poor in fiber, change in infant formulas.
Acute stressor: Stressful events (change of home, change of school, loss of near one, major changes in family, and sibling rivalry), intercurrent illness.
Child’s postponing defecation—too busy (morning school), too engrossed (TV, mobile, and video games), just lazy to go to toilet.
Forceful and too early toilet training.
Sedentary lifestyle and decreased outdoor playtime.
Medicines: Some medicines to cause constipation as a side effect.
Organic causes (rarely): Hirschsprung’s disease, congenital anomalies (anal stenosis, anteriorly placed anus, and spinal cord anomalies), hypothyroidism, and lead poisoning.
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