Abstract

A 1992 study showed that 7% of patients presenting to a pediatric emergency department (ED) with abdominal pain were diagnosed with constipation. Misdiagnosis of constipation may lead to multiple unresolved physician visits, utilization of emergency medical services, high doses of ionizing radiation, unnecessary laboratory tests, and even surgical procedures. This issue examines existing literature on constipation, though few randomized double-blind, controlled clinical trials of good quality existed in the literature until recently. The study populations in many articles are obtained from pediatric specialty clinics with subjects who carry a known diagnosis of chronic and often poorly controlled constipation. Analysis of the literature is hampered by lack of a concrete definition of constipation and the variability in outcome measures. The primary evidence-based recommendations are based on published guidelines and include management of constipation in children divided into 3 stages of therapy: (1) disimpaction, (2) maintenance therapy, and (3) behavior modification. Special consideration should be given to neonates and to children with pre-existing medical conditions.

Keywords: pediatric constipation, constipation, diarrhea, pediatric abdominal pain, pediatric gastroenterology, stool, defecation, encopresis, Hirschsprung disease