Constipation is common in childhood, and almost 50% of cases become chronic. Many parents may not recognise the signs and symptoms of constipation, and very few relate the presence of soiling to constipation. Signs and symptoms of childhood constipation include:
- infrequent bowel activity
- foul smelling wind and stools
- occasionally passing large (or enormous stools) or frequent small pellets
- withholding or straining
- soiling or overflow
- recurrent abdominal pain and discomfort
- poor appetite and painful defecation.
Not infrequently, blood may be seen on toilet paper after defecation, usually due to an anal fissure.
Diagnosis of constipation is usually based on eliciting a typical history and clinical examination, and rarely may require an X-Ray of the abdomen. Most cases of constipation in children are functional, however occasionally may be organic, for example, Hirschprung disease, neuronal degeneration, hypothyroidism etc.
Functional constipation must be treated early and involve regular toileting habits, medication if indicated, parental involvement, education and follow ups.