Constipation is an extremely common disorder in childhood and is responsible for up to 25%of all pediatric gastroenterological consultations and 3% of all pediatric outpatient visits. In 90% of the cases the disorder is functional in origin and in only 10% is there an underlying organic disorder.
Common organic causes of childhood constipation include:
congenital defects of the gut; neurologic disease especially
cerebral palsy, spinal cord disorders and hypotonia; endocrine and metabolic disorders (hypothyroidism, cystic fibrosis, hypercalcemia, diabetes mellitus, renal acidosis), and the use of constipating drugs such as some antacids, sucralfate, iron, codeine-containing medications, imipramine, phenytoin, etc. The commonest of the congenital defects is
Hirschsprung’s disease, which has an incidence of 1 in 4,500
live births compared to 1 in 7,000 live births with anorectal
malformations, and 1 in 40,000 with other enteric neuromuscular disorders. Fewer than 5% of children presenting for the first time with constipation have demonstrable organic disease...
Constipation is a frequent reason for consulting a pediatrician.
As a symptom, constipation can be due to various etiologies
in terms of frequency, nature and seriousness. Constipation
may be of medical or surgical origin or idiopathic.
Surgical etiologies are mainly represented by Hirschsprung’s
disease. It is the main differential diagnosis even if it is 50
times less frequent than idiopathic or functional constipation.
A thorough history and physical examination, including
anal examination, are the best way to reach a diagnosis.
No other examination is required in most of the cases and all
investigations have to be managed according to clinical considerations...
Fecal incontinence is defined as the passage of stools in an inappropriate place. This frustrating symptom is a source of
considerable distress and embarrassment for the child and
his/her family. Pediatric fecal incontinence can be divided
into 2 main categories: organic fecal incontinence, e.g.,
resulting from anorectal malformations or neurogenic abnormalities,
and functional fecal incontinence. This review will only address functional fecal incontinence in children, and the definition, epidemiology, pathophysiology and recent updates on the clinical and diagnostic aspects of functional fecal incontinence will be discussed.
Childhood constipation is a worldwide problem. It is one of
the more common complaints presented to both general
pediatricians and pediatric gastroenterologists. Treatment
for chronic constipation is challenging and often requires
long-term follow-up and medication use. Despite its high
prevalence, few randomized trials have been performed to
investigate the efficacy of different interventions used to
treat this condition. In this review we will discuss current
treatment options for childhood constipation and address
some of the most frequently asked questions and misconceptions among parents and physicians.