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Chapter-05 Constipation

BOOK TITLE: Recent Advances in Pediatrics (Volume 20: Hot Topics)

Author
1. Tiwari Satish K
2. Kale Pratibha
ISBN
9789350252475
DOI
10.5005/jp/books/11254_5
Edition
1/e
Publishing Year
2011
Pages
5
Author Affiliations
1. Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India, Medical College, Amravati, India, Medical College, Amravati, Maharashtra, India, Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram, Maharashtra, India, Medical College Amravati, India, Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sevagram, Maharashtra, India, PDM Medical College, Amravati, Maharashtra, India
2. Dr PDM Medical College, Amravati, Maharashtra, India, Medical College, Amravati, Maharashtra, India, Medical College Amravati , India
Chapter keywords

Abstract

The term, constipation, denotes decrease in frequency of bowel movements and difficult/painful passage of hard stools. Persistent constipation is common and also sought with long-term health implications, including abdominal distention, discomfort and even colic, psychological difficulties, hemorrhoids and hernias. In a large majority of the cases, simple dietary irregularities or inadequacies are the cause. Hypothyroidism is one of the important organic causes which must be suspected, diagnosed and treated early to prevent mental subnormality. Among the surgical causes rank the Hirschsprung disease and anal fissure. Clinical examination is important to rule out organic causes. Investigations, depending on the merits of the case, include plain X-ray of abdomen; barium enema; imaging studies (CT scan, MRI of brain and spine) to rule out cerebral palsy and spinal cord lesions; sweat chloride estimation to exclude cystic fibrosis; renal function tests; measurement of blood level for lead poisoning. Management requires explanation, support and encouragement not only to the patient but also to the family. General measures like adequate dietary intake, fiber intake and advice from a dietitian are important. Medical management includes emptying of rectum and distal colon by enema followed by a stool softener, say lactulose. Management of specific diseases, including surgical conditions, causing constipation should be as per standard protocol. Intractable constipation may well respond to cisapride. With proper care and treatment long term prognosis in most of the cases is usually satisfactory.

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