Childhood constipation.

BACKGROUND: Constipation is best defined as difficulty passing stools that may be infrequent (≤2 per week), painful and associated with stool retention. Childhood constipation is common, with a prevalence of 3-30% worldwide. Most constipation in children is functional and related to behavioural withholding after an unpleasant stool event. Successful diagnosis and management can occur in primary care, and specialist referral is only needed for refractory cases or concerns regarding organic pathology.

OBJECTIVE: This article aims to provide a structure for evaluating, diagnosing and managing childhood functional constipation in general practice.

DISCUSSION: Structured history and examination can screen for organic pathology or red flags that require specialist referral. Investigations such as abdominal X-ray are not routine. Early management of childhood constipation provides improved quality of life for patients and their families. Management, including disimpaction and maintenance, should maintain continuity of care and provide long-term support for families.