Constipatin in children.doc

Constipation in children Croffie Joseph M Indiana University School of Medicine, James Whitcomb Riley Hospital for Children, Indianapolis, Indiana, USA ??? Abstract ??? Constipation is a common problem throughout the world. It occurs in about 10-20% of adults in Western Countries and 0.3% to 28% of children worldwide. Most childhood constipation results from intentional withholding of stool following a painful experience with defecation. Thus, an extensive evaluation is often not necessary in a child presenting with constipation. Treatment should include education, evacuation of the rectum with oral or rectal laxatives if an impaction is present, laxatives to ensure soft stools and behavior modification. ??? Keywords: Constipation; Fecal retention; Encopresis ??? Constipation is a common problem throughout the world. It occurs in both adults and children. In the United States, 3 % of visits to a pediatrician and 25% of visits to a pediatric gastroenterologist are for problems related to constipation and 34% of British children aged 4 to 11 years have experienced constipation.[1], [2] ??? Definition ??? Constipation is a symptom, not a disease or a sign. For this reason, a precise definition has been elusive. Constipation has a different meaning for different people and often reflects an individuals view of what the normal pattern of defecation should be. Thus, its definition has included terms such as difficult or infrequent bowel movements, painful defecation, passage of hard stools and a sensation of incomplete evacuation of stool. The practice guidelines of the North American Society for Pediatric Gastroenterology Hepatology and Nutrition (NASPGHAN) defined constipation in children as a delay or difficulty in defecation, present for 2 or more weeks and sufficient to cause significant distress to the patient.[3] Recently, a group of pediatric gastroenterologists and pediatricians meeting in Paris to seek a consensus on terminology for childhood constipation define