Materiały źródłowe

• #1 Constipation in infants and children: Evaluation – UpToDate

  https://www.uptodate.com/contents/constipation-in-infants-and-children-evaluation

  Constipation affects up to 30 percent of children and accounts for an estimated 3 to 5 percent of all visits to pediatricians. […] Functional constipation is responsible for more than 95 percent of cases of constipation in healthy children one year and older and is particularly common among preschool-aged children. […] Although it is common, it is important to evaluate affected children to identify the few that have organic causes of constipation.

• #2 Constipation in Children – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/symptoms-in-infants-and-children/constipation-in-children

  Constipation is very common among children. It accounts for up to 5% of children’s visits to the doctor. […] In 95% of children, constipation results from dietary issues and behavioral issues. Constipation that results from dietary or behavioral issues is called functional constipation. […] Dietary issues that cause constipation include a diet that is low in fluids and/or fiber (fiber is present in fruits, vegetables, and whole grains). […] Behavioral issues that may be associated with constipation include stress (as may be felt when a sibling is born), resistance to toilet training, and a desire for control. […] In approximately 5% of children, constipation results from a physical disorder, medication, or toxin. […] Constipation that results from a disorder, medication, or toxin is called organic constipation and needs to be evaluated by a doctor.

• #3 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract, causing the stool to become hard and dry. […] Many factors can contribute to constipation in children, including: […] Withholding. Your child may ignore the urge to have a bowel movement because he or she is afraid of the toilet or doesn’t want to take a break from play. Some children withhold when they’re away from home because they’re uncomfortable using public toilets. […] Painful bowel movements caused by large, hard stools also may lead to withholding. If it hurts to poop, your child may try to avoid a repeat of the distressing experience. […] Toilet training issues. If you begin toilet training too soon, your child may rebel and hold in stool. If toilet training becomes a battle of wills, a voluntary decision to ignore the urge to poop can quickly become an involuntary habit that’s tough to change.

• #4 Symptoms & Causes of Constipation in Children – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/constipation-children/symptoms-causes

  Children most often get constipated from holding in their stool to avoid or delay having a bowel movement. […] When stool stays too long in the colon, the colon absorbs too much fluid from the stool. Then the stool becomes hard, dry, and difficult to pass. […] Certain health and nutrition problems can cause constipation in children […] not eating enough fiber […] not drinking enough liquids or dehydration […] Hirschsprung disease […] celiac disease […] disorders that affect your brain and spine, such as spina bifida […] spinal cord or brain injuries […] conditions that affect their metabolism, such as diabetes […] conditions that affect their hormones, such as hypothyroidism […] problems that can block or narrow the colon or rectum, including tumors.

• #5 Constipation in Children: Causes, Signs & Treatment | CHOC

  https://choc.org/programs-services/gastroenterology/constipation/

  Constipation is a condition in which a person has painful or infrequent bowel movements that result in the passage of small amounts of hard, dry stool. Constipation is common in children, accounting for 5% of general pediatric visits and 25% of pediatric gastroenterology visits each year. […] More than 90 percent of constipated children have “functional” constipation, which is constipation without any underlying disease. […] Constipation is typically caused by an external factor or change in diet/lifestyle, but more severe or chronic cases of constipation can be due to an underlying condition. Some of the most common causes of constipation in children include: medications, lack of exercise, not enough liquids, not enough fiber in the diet, irritable bowel syndrome, ignoring the urge to have a bowel movement, changes in habits or lifestyle, and problems with intestinal function. […] Some diseases that commonly cause constipation include celiac disease, hypothyroidism, inflammatory bowel disease, spinal cord issues, neuromuscular diseases, lead poisoning, and anal malformations.

• #6 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. […] Functional constipation, for which there is no organic cause, is the most common type of constipation in children and adolescents, accounting for 95% of cases. Only 5% of constipation cases in children and adolescents can be attributed to an underlying etiology such as Hirschsprung disease, cystic fibrosis, Down syndrome, anorectal malformations, neuromuscular disorders, spinal cord abnormalities, or celiac disease. Certain medications such as opiates, antacids, or anticholinergics can also cause constipation. […] Constipation commonly starts with the transition to solid foods, toilet training, or school entry. The median age of onset of functional constipation is 2.3 years of age.

• #6 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation leads to painful bowel movements, which can cause the child to withhold stool. Withholding stool increases colonic water absorption, making the stool firmer and more difficult to pass. […] Although children may have painful or traumatic defecation experiences, resulting in stool withholding, adolescents suppress the urge to defecate as a learned behavior. […] There are also psychological and behavior factors that can result in functional constipation, particularly in patients with autism and attention-deficit/hyperactivity disorders.

• #7 Pediatric Functional Constipation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537037/

  Functional constipation is commonly seen in preschool children, especially during toilet training. Although specific individuals may be more prone to constipation than others, a common cycle of events or triggers often leads to functional constipation. […] The most common event or trigger is painful or frightening defecation; a single event alone can precipitate functional constipation. […] Functional constipation is defined as functional constipation if there is no underlying organic cause, which is the case in up to 95% of children. This condition can be seen in healthy children 1 year and older and is particularly common among preschool-aged children. […] It is often not caused by any underlying systemic cause or anatomical defect. It is usually multifactorial, including environmental conditions, stress, diet, coping skills, and social support.

• #8 Constipation in Children – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/symptoms-in-infants-and-children/constipation-in-children

  Constipation in children is divided into 2 main types: […] Organic causes of constipation involve specific structural, neurologic, toxic/metabolic, or intestinal disorders. They are rare but important to recognize. […] The most common organic cause is Hirschsprung disease. […] Functional constipation is difficulty passing stools for reasons other than organic causes. […] Children are prone to develop functional constipation during 3 periods: After the introduction of cereals and solid food, During toilet training, During the start of school. […] Stress, desire for control, and sexual abuse are also some of the functional causes of stool retention and subsequent constipation.

• #9 What causes chronic constipation in children?

  https://www.topdoctors.co.uk/medical-articles/what-causes-chronic-constipation-in-children

  Constipation in children is generally considered when a child is passing fewer than three bowel movements each week. The condition is described as being chronic when these infrequent bowel movements or difficult passage of stools persist beyond several weeks. […] In children constipation occurs when stools move too slowly through the gastrointestinal tract (from mouth to bottom). This can quickly become a vicious cycle, where stools become harder and larger making them even more difficult to pass and therefore they move even more slowly through. There are many contributing factors that can contribute to constipation in children: […] A common factor that contributes to childhood constipation is a poor, low-fibre, diet. One of the common reasons that children get constipated is a change from an entirely liquid-based diet (breast or bottle-fed infants) to one that includes solids.

• #9 What causes chronic constipation in children?

  https://www.topdoctors.co.uk/medical-articles/what-causes-chronic-constipation-in-children

  Many of the children and young people that come to me with severe chronic constipation will not have a healthy, balanced, high-fibre diet. […] Many children tend towards constipation when their daily routine is upset or altered. Common examples are around toilet training, starting nursery or primary school and summer holidays (travel and hot weather). Generally any period when the child is stressed in some way will be associated with an increased risk of constipation. […] Some children will have an allergy to the protein within cow’s milk. Consuming too many dairy products (cheese, cow’s milk etc.) can contribute to constipation in some children. […] Thankfully less than five per cent of children with chronic constipation have an underlying medical condition. Warning signs that a child may have an underlying condition would be a delayed passage (over twenty-four hours) of meconium (the first, black, sticky stool that a baby passes after birth), ribbon stools (very thin long stools), a tummy that is extremely distended or swollen, explosive watery stools, or any child that looks unwell or is failing to thrive. In these circumstances, an experienced specialist should assess the child to make sure there are no underlying conditions causing their constipation.

• #9 What causes chronic constipation in children?

  https://www.topdoctors.co.uk/medical-articles/what-causes-chronic-constipation-in-children

  Chronic constipation can literally ruin children’s lives by dominating family life, leaving them soiling their pants, frequently considered smelly and dirty by their peers, and ultimately negatively affecting their behaviour and mental health. It is critical that childhood constipation is addressed before it reaches this point.

• #10 Causes of Chronic Constipation – Department of Pediatrics

  https://med.virginia.edu/pediatrics/clinical-and-patient-services/patient-tutorials/chronic-constipation-encopresis/causes/

  Many parents have been told their child became constipated because of drinking too much milk or eating too much cheese. What we eat affects our bowel habits, but diet alone is usually not the cause of chronic constipation. As a group, children who develop chronic constipation tend to drink less fluid than children who do not become constipated, but in most cases it is not until the child begins to associate pain with passing bowel movements that constipation develops. […] There are other reasons that children may become constipated but they are very uncommon: Hirschsprungs disease, Neurological abnormalities, Hypothyroidism. […] Most of the time, pain with bowel movements starts when a child passes a very big or hard bowel movement. […] When a young infants diet changes from breast milk to formula, or from formula to cows milk, bowel movements often become much harder. This also happens in older children when when they begin eating solid foods.

• #11 Causes of Chronic Constipation – Department of Pediatrics

  https://med.virginia.edu/pediatrics/clinical-and-patient-services/patient-tutorials/chronic-constipation-encopresis/causes/

  Following a bout of diarrhea, some children get a little dehydrated and as the diarrhea goes away, the intestine does what it is supposed to do and absorbs salt and water. This causes the bowel movement to become harder. This can also happen after surgery or some other traumatic event. […] It really doesnt matter why the pain starts. . . what is important is that the child passes a big and/or hard bowel movement and it hurts! […] Once children begin to fear passing a bowel movement, the cycle of chronic constipation has begun. […] Children with chronic constipation almost always have stool in the rectum. […] Over time, the child learns to ignore this signal. This is not a conscious decision, but something that just happens. […] Eventually, the child will pass a bowel movement, but it is often very large and very hard, so there will be lots of pain. This reinforces the childs fear, so the problem will go on and on and on . . . as the cycle of pain and fear continues, passing bowel movements becomes more and more abnormal.

• #12 Causes of Chronic Constipation – Department of Pediatrics

  https://med.virginia.edu/pediatrics/clinical-and-patient-services/patient-tutorials/chronic-constipation-encopresis/causes/

  Not surprisingly, in children suffering from chronic constipation, the coordination of these processes gets very confused. First, they often do not get the urge to pass a bowel movement in the normal way, but rather, as pain or cramps. Second, when they start straining, instead of using all their muscles together to push the bowel movement out, they often push with some muscles and pull with others they grunt and strain and seem to push as hard as they possibly can, but they are usually fighting against themselves. Finally, because they are pushing and straining so hard, rather than relaxing the external sphincter to let the bowel movement out, they often squeeze or tighten the sphincter.

• #13 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  Changes in diet. Not enough fiber-rich fruits and vegetables or fluid in your child’s diet may cause constipation. One of the more common times for children to become constipated is when they’re switching from an all-liquid diet to one that includes solid foods. […] Changes in routine. Any changes in your child’s routine such as travel, hot weather or stress can affect bowel function. Children are also more likely to experience constipation when they first start school outside of the home. […] Medications. Certain antidepressants and various other drugs can contribute to constipation. […] Cow’s milk allergy. An allergy to cow’s milk or consuming too many dairy products (cheese and cow’s milk) sometimes leads to constipation. […] Family history. Children who have family members who have experienced constipation are more likely to develop constipation. This may be due to shared genetic or environmental factors. […] Medical conditions. Rarely, constipation in children indicates an anatomic malformation, a metabolic or digestive system problem, or another underlying condition.

• #14 8 common causes of constipation in kids – Children’s Health

  https://www.childrens.com/health-wellness/8-common-causes-of-constipation-in-kids

  If your child isn’t drinking enough fluids each day, their poop can be hard and dry making it difficult to push out. […] Even small changes to your child’s routine can disturb healthy bowel habits. […] Surprisingly, a child’s video game hobby may contribute to constipation. […] Potty training is a big transition for little kids. It can leave some children feeling anxious, so they end up withholding stool instead of asking to use the bathroom. […] Some medicines or dietary supplements can slow the bowels and lead to constipation.

• #15 8 common causes of constipation in kids – Children’s Health

  https://www.childrens.com/health-wellness/8-common-causes-of-constipation-in-kids

  Constipation, or difficulty pooping, affects millions of kids each year. According to a 2018 study, about 18% of toddlers and 14% of children and teens suffer from constipation. […] Children can become constipated for a variety of reasons, ranging from certain foods or a lack of fiber in their diet to stress or side effects from a medication. […] Diet is a leading cause of constipation. Because of the ease of packaged snacks, many children eat a diet of too many processed foods. These foods often contain little to no fiber, which is essential for regular, healthy bowel movements. […] Excessive dairy intake is a common association with constipation, and we recommend reducing intake of dairy rich foods like cheese and milk if your child is constipated. […] New research continues to illustrate the connection between the mind and the gut. Stress and anxiety can have a big effect on digestion, causing constipation or diarrhea.

• #16 Constipation in Children | Phoenix Children’s Hospital

  https://phoenixchildrens.org/specialties-conditions/constipation-children

  Constipation is when a child has very hard stools and has fewer bowel movements than normal. It is a very common gastrointestinal (GI) problem. […] What causes constipation in a child? Stool gets hard and dry when the large intestine (colon) takes in (absorbs) too much water. […] If your child has constipation, the colon’s muscle movements are too slow. This makes the stool move through the colon too slowly. The colon absorbs too much water. The stool gets very hard and dry. […] There are many reasons why a child may become constipated. Some common diet and lifestyle causes include: Eating too many foods that are high in fat and low in fiber. These include fast foods, junk foods, and soft drinks. […] Not drinking enough water and other fluids. […] Having a change in diet. This includes when babies change from breastmilk to formula, or when they start eating solid foods.

• #17 Childhood constipation

  https://www.racgp.org.au/afp/2017/december/childhood-constipation

  Constipation is best defined as difficulty passing stools that may be infrequent (2 per week), painful and associated with stool retention. […] Most constipation in children is functional and related to behavioural withholding after an unpleasant stool event. […] Constipation in children is usually functional or idiopathic, and related to behavioural withholding after a painful or unpleasant stool event. […] Functional constipation describes constipation that does not have an organic aetiology. […] Dietary factors, including inadequate fibre and water intake, are rarely the primary cause of constipation but may contribute. […] Organic disorders are uncommon, but consider the possibility of coeliac disease or cows milk protein allergy if the history is suggestive. […] If there are ongoing symptoms of constipation after six months of appropriate treatment, a referral for specialist care and a second opinion is warranted.

• #18 Constipation in children – NHS

  https://www.nhs.uk/baby/health/constipation-in-children/

  Constipation in children has many possible causes. Sometimes there’s no obvious reason. […] Some of the possible causes include: not eating enough high-fibre foods like fruit and veg, not drinking enough fluids, feeling pressured or being regularly interrupted while potty (or toilet) training, feeling worried or anxious about something such as moving house, the arrival of a new baby, or starting nursery or school. […] If your child is constipated they may find it painful to poo, which may mean they do not want to try to poo. This can create a vicious circle; the more they hold back, the more constipated they get.

• #19 Pediatric Constipation Etiologies

  https://mobile.fpnotebook.com/GI/Peds/PdtrcCnstptnEtlgs.htm

  Hypokalemia […] Hypercalcemia […] Cystic Fibrosis […] Uremia […] Porphyria […] Mitochondrial Disorders […] Connective Tissue Disorders […] Infant Botulism […] Necrotizing Enterocolitis […] Myotonic Dystrophy […] Amyotonia congenita […] Mental Retardation […] Psychosis […] Prune-Belly Syndrome […] Pseudo-obstruction syndrome […] Mood Disorder (Major Depression, Generalized Anxiety Disorder) […] Changes in home (birth of sibling, parents divorce) […] Starting at a new school […] Toilet Phobia […] Sexual abuse.

• #20 Constipation | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/c/constipation

  Constipation is a common problem for children. […] Most times, there are no exact reasons why children have trouble with constipation. Your child’s healthcare team might call this functional constipation. Some things that might add to your child’s trouble with constipation are: […] Diet: Some children eat too many foods that are high in fat and low in fiber (fast foods, junk foods, soda). Also, some children do not drink enough water. […] Lack of exercise: Exercise helps move food through the intestines. Children who watch too much TV or play too many video games may not be getting enough exercise. […] Busy children: Some children are too busy playing and forget to go to the bathroom. They ignore their bodies signals that it is time to go sit and poop. […] Behaviors: Sometimes children may feel too much pressure to potty train and will resist potty training. Also, children might hold back the urge to poop because they refuse to use public or even school bathrooms.

• #21 Toddler Constipation – WebMD: Causes, Symptoms, and Treatments

  https://www.webmd.com/children/toddler-constipation-causes-treatments

  Seeing an empty toilet day after day might fill parents with panic, but constipation in toddlers isn’t usually a sign of any serious disease. Most often it’s caused by a problem that’s easy to solve, like diet or ignoring the urge to go. […] A variety of things can cause constipation in toddlers, from diet to medication. Here are a few of the most common causes: […] The culprit in many cases of toddler constipation is a diet that’s too heavy in processed foods, dairy, and sweets, and too light in fiber (like whole grains, fruits, and vegetables). Not getting enough fluid can also lead to constipation, because it makes the stools harder. […] Some medications or supplements can lead to a constipated toddler, including high-dose iron supplements or narcotic pain medication. […] In rare cases, an anatomical problem with the intestines, anus, or rectum can cause chronic constipation.

• #22 Table: Organic Causes of Constipation in Infants and Children-MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/multimedia/table/organic-causes-of-constipation-in-infants-and-children

  Abdominal pain and distention […] Colonic transit time […] Adverse drug effects […] Use of anticholinergics, antidepressants, chemotherapeutics, or opioids […] Toxins […] Infant botulism […] New onset of poor suck, feeding difficulties, anorexia, drooling […] Weak cry […] Irritability […] Ptosis […] Descending or global hypotonia and weakness […] Lead toxicity […] Most likely asymptomatic […] Possible intermittent abdominal pain, sporadic vomiting, fatigue, irritability […] Loss of developmental milestones

• #23 An Inside Look at the Real Causes of Toddler Constipation

  https://pediatrixmd.com/baby-care/an-inside-look-at-the-real-causes-of-toddler-constipation/

  Constipation is defined as having three or fewer bowel movements per week, and while some children might pass stool every day, others can go days at a time with no ill effects. […] There are many different causes of toddler constipation. The most typical are dehydration from not getting enough water and not eating enough fiber in their diet. Other causes are more complex and can include medicines such as anticonvulsants, narcotics, antispasmodics, and anticholinergics. […] Extreme and unusual causes of toddler constipation including irritable bowel syndrome, cancer, celiac disease, metabolic disorders, and hormonal imbalances. Other causes are psychological, such as feeling stress over toilet training, embarrassment, or fears of having a painful bowel movement.

• #24 Symptoms and Signs of Constipation in Children: Treatment

  https://www.emedicinehealth.com/constipation_in_children/symptom.htm

  Causes of constipation in children can be medications such as coal medications, antacids, antidepressants, anticonvulsants, chemotherapy, and pain medication that includes narcotics. […] Medical disorders that can cause chronic constipation in children include hypothyroidism, a congenital condition like Hirschsprung’s disease (lack of nerve cells), diabetes, abnormal electrolyte levels, lead poisoning, cystic fibrosis, spinal cord problems, and mental retardation. […] The majority of children with constipation have it intermittently and do not have a medical disease or disorder.

• #25 Constipation in children: Causes and when to worry

  https://www.medicalnewstoday.com/articles/constipation-in-children-when-to-worry

  Constipation can have various causes. It is common in children. […] Constipation in children can happen for various reasons. […] Constipation frequently occurs when the stool passes slowly through the digestive tract. This causes the colon to absorb too much water, resulting in hard, dry stool. This may make it uncomfortable to have a bowel movement. […] Constipation can occur due to a lack of fiber or dehydration. However, it can also be a symptom of an underlying condition such as: […] Some children may hold in their stool, usually involuntarily, which can cause constipation. They may do this due to anxiety and stress surrounding going to the toilet. […] Certain medications and dietary supplements may also cause constipation in children, such as anticonvulsants, iron supplements, and antacids.

• #26

  https://www.koruhastanesi.com/causes-of-constipation-in-children-3324-5

  Constipation is one of the most common problems faced by parents. It affects both adults and children. Learn about its causes and treatment options here! […] The cause of this problem varies depending on the age of the child. […] In infants, constipation is often caused by an inadequate diet. […] In older children, constipation is usually due to dietary changes. […] A lack of exercise can cause constipation. […] Kids who spend more than three hours per day watching television or playing video games are at greater risk for constipation. […] If your child has been diagnosed with constipation, talk to your doctor about any medications he or she might be taking. These drugs can cause constipation as well.

• #27 Constipation

  https://www.seattlechildrens.org/conditions/a-z/constipation/

  Can’t pass a stool or pain when passing a stool. […] Crying when passing a stool (bowel movement or BM) or […] Can’t pass a stool after straining or pushing longer than 10 minutes or […] 3 or more days without passing a stool (exception: breastfed and over 1 month old). […] High Milk Diet. Milk and cheese are the only foods that in high amounts can cause constipation. It causes hard pale stools. This is why you want your child to eat a well-balanced diet. […] Low Fiber Diet. Fiber is found in vegetables, fruits and whole grains. Fiber keeps stools soft, bulky and easy to pass. A low fiber diet causes hard, small stools. […] Low Fluid Intake. This can also cause stools to be dry and harder to pass. It’s rarely the only cause of constipation. […] Lack of Exercise. Exercise also keeps the bowel from slowing down. Not a cause in children unless they are confined to bed.

• #28 Constipation and children | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation-and-children

  The child may not be getting enough exercise. […] True constipation in babies is rare and should always be checked by a doctor. Causes of constipation in babies include: formula is too strong if your baby is bottle-fed, make sure the formula is made up correctly, so that there is not too much formula powder for the amount of water. […] Using a different formula changes to the milk formula (especially when swapping to follow-on formula or cows milk). […] Not enough drinks in warm weather, bottle-fed infants require extra fluid such as cooled, boiled water between formula feeds. […] Difficulty passing poo sometimes a hard poo can cause a little tear or crack in the skin around the anus and this can hurt the baby. The baby seems to know that it hurts to do poo and so holds on. Then the poo becomes even harder and will be more painful to pass.

• #29 Constipation in Children – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/symptoms-in-infants-and-children/constipation-in-children

  The most common disorder that causes organic constipation is Hirschsprung disease (an inadequate nerve supply to the large intestine). […] Other causes of organic constipation include birth defects of the anus, cystic fibrosis, metabolic and electrolyte disorders, spinal cord problems, hormonal disorders, intestinal disorders, medications, and toxins.

• #30 Constipation in children – Wikipedia

  https://en.wikipedia.org/wiki/Constipation_in_children

  A number of diseases present at birth can result in constipation. They are as a group uncommon with Hirschsprung’s disease (HD) being the most common. […] There are also congenital structural anomalies that can lead to constipation, including anterior displacement of the anus, imperforate anus, strictures, and small left colon syndrome. […] Some symptoms that may indicate an underlying disease include bowel movements that contain blood, severe abdominal bloating, peri-anal fistula, absent anal wink reflex, sacral dimple, and failure to thrive.

• #31 Table: Organic Causes of Constipation in Infants and Children-MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/multimedia/table/organic-causes-of-constipation-in-infants-and-children

  Organic Causes of Constipation in Infants and Children […] Anatomic […] Anal stenosis […] Delayed passage of stool in the first 2448 hours of life […] Explosive and painful stools […] Abdominal distention […] Abnormal appearance or position of the anus […] Tight anal canal detected by digital examination […] History and physical examination […] Anteriorly displaced anus […] Severe chronic constipation with marked straining and pain when stool is passed […] Typically no response to aggressive use of stool softeners and cathartics […] Anal opening not located in the center of the pigmented area of the perineum […] Imperforate anus […] Abdominal distention […] No passage of stool […] Abnormal appearance or position of the anus or possibly no anus […] Endocrine or metabolic disorders

• #31 Table: Organic Causes of Constipation in Infants and Children-MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/multimedia/table/organic-causes-of-constipation-in-infants-and-children

  Diabetes insipidus […] Polydipsia […] Polyuria […] Excessive crying quieted with water intake […] Weight loss […] Vomiting […] Hypercalcemia […] Nausea, vomiting […] Muscle weakness […] Abdominal pain […] Anorexia, weight loss […] Polydipsia […] Polyuria […] Hypokalemia […] Muscular weakness […] Polyuria, dehydration […] History of growth failure […] Possibly history of aminoglycoside, diuretics, cisplatin, or amphotericin use […] Hypothyroidism […] Poor feeding […] Bradycardia […] Large fontanelles and hypotonia in neonates […] Cold intolerance, dry skin, fatigue, prolonged jaundice […] Spinal cord defects […] Myelomeningocele […] Grossly visible lesion in vertebral spine at birth […] Decrease in lower-extremity reflexes or muscular tone

• #32 Assessing indicators and clinical differences between functional and organic childhood constipation: a retrospective study in pediatric gastroenterology clinics

  https://www.e-cep.org/journal/view.php?number=20125555624

  In this study, 105 patients (17%) had an OC. However, Talachian et al. reported lower percentage of OC (13%, 4.2% and 1.3%, respectively). This might be also related to the variation in the study setting and patients demography among different studies. […] The most common organic cause was CMPA (5.7%). Similarly, Altamimi reported CMPA as one of the leading causes for OC. CMPA is the most common cause of constipation in the first 3 years of life. […] The presence of allergic inflammation of the rectal mucosa can lead to increased resting anal sphincter pressure and an abnormal relaxation of the anal canal causing chronic constipation, that disappear after elimination of cows milk protein from the diet. […] In this study, the most common associated disease was enuresis (n=21, 3.4%), followed by SCD (n=19, 3%), and GERD (n=18, 2.9%).

• #33 Table: Organic Causes of Constipation in Infants and Children-MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/multimedia/table/organic-causes-of-constipation-in-infants-and-children

  Vomiting […] Diarrhea or constipation […] Hematochezia […] Anal fissures […] Growth and weight faltering […] Symptom resolution with elimination of cow’s milk protein […] Cystic fibrosis […] Delayed passage of meconium or meconium ileus in the neonate […] Possible repeated episodes of small-bowel obstruction (meconium ileus equivalent) in older children […] Growth and weight faltering […] Hirschsprung disease […] Delayed passage of meconium […] Abdominal distention […] Tight anal canal detected by digital examination […] Irritable bowel syndrome […] Chronic recurrent abdominal pain […] Often alternating diarrhea and constipation […] Feeling of incomplete evacuation […] Passage of mucus […] No anorexia or weight loss […] Intestinal pseudo-obstruction […] Nausea, vomiting

• #34 Constipation (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/constipation.html

  Constipation can be due to a diet that doesn’t include enough water and fiber, which help the bowels move as they should. […] Sometimes, medicines like antidepressants, pain medicines, and those used to treat iron deficiency can cause constipation. […] Stress also can lead to constipation. Kids can get constipated when they’re anxious about something, like starting at a new school or problems at home. […] Some kids get constipated because of irritable bowel syndrome (IBS), which can happen when they’re stressed or eat certain trigger foods, which often are fatty or spicy. […] In rare cases, constipation is a sign of other medical illnesses. So talk to your doctor if your child continues to have problems or if the constipation lasts for 2 to 3 weeks.

• #35 8 Common Causes of Constipation in Kids – My Pedia Clinic

  https://mypediaclinic.com/blog/8-common-causes-of-constipation-in-kids/

  Constipation is a common problem in both kids, and it affects millions of kids every year. It can be caused by various factors, including diet, lifestyle, and medication. […] Processed foods are one of the main causes of constipation in kids. A lack of fiber is another common cause of constipation in kids. Kids who don’t get enough exercise are also more likely to develop constipation. Many kids are sensitive to dairy products, and consuming too much dairy can lead to constipation. Dehydration is another common cause of constipation in kids. Stress can also lead to constipation in kids. Some medications can also cause constipation in kids. Irritable bowel syndrome is a condition that causes the intestines to become inflamed and can lead to constipation.

• #36 Pediatric Constipation Etiologies

  https://mobile.fpnotebook.com/GI/Peds/PdtrcCnstptnEtlgs.htm

  Intussusception […] Volvulus […] Malrotation […] Presacral Teratoma (or other pelvic mass) […] Meconium plug […] Rectal Prolapse […] Inflammatory Bowel Disease […] Anteriorly displaced anus […] Anal Fissure […] Bowel stricture […] Scleroderma […] Dermatomyositis […] Systemic Lupus Erythematosus […] Disordered or absent abdominal musculature […] Aganglionic Megacolon (Hirschprung’s Disease) […] Chagas’ Disease […] Von Recklinghausen’s Disease […] Multiple Endocrine Neoplasm (MEN) Type 2 […] Internal anal sphincter Achalasia […] Neuronal intestinal dysplasia […] Visceral Myopathy […] Hypothyroidism […] Hypoparathyroidism […] Renal Tubular Acidosis […] Diabetes Insipidus […] Diabetes Mellitus […] Vitamin D Intoxication […] Idiopathic Hypercalcemia

• #37 Toddler Constipation: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17785-constipation-in-children

  Constipation most frequently occurs due to a low-fiber diet, dehydration, changes in routine or resistance to toilet training. […] Toddlers often become constipated because they hold in their stool. As a result, their colon absorbs too much fluid and their poop becomes dry and hard to pass. […] Other causes of constipation in toddlers include a low-fiber diet, not getting enough fluids, certain medications, disorders such as Hirschsprung disease or celiac disease, birth defects such as spina bifida, health conditions that affect their metabolism such as diabetes, medical conditions that affect their hormones such as hypothyroidism, illnesses that cause a loss of appetite, and stress caused by school or by changes in routine, weather or travel.

• #38 Pediatric Constipation Etiologies

  https://mobile.fpnotebook.com/GI/Peds/PdtrcCnstptnEtlgs.htm

  Functional Constipation is most common cause […] Infants: Consider maternal medications in Breast fed infants […] Cystic Fibrosis […] Hirschsprung’s Disease (delayed meconium passage 48 hours) […] Congenital disorders […] Anteriorly displaced anus […] Older children: Hypothyroidism […] Anorexia […] Neuromuscular disorders […] Excessive cows milk […] Cow’s Milk Protein Intolerance (blood in stool) […] Transition from Breast Milk to formula […] Transition from strained foods to table foods […] Lack of privacy (e.g. start of daycare or school) […] Lack of bulk in diet […] Under-nutrition […] Pediatric Dehydration […] Celiac Disease […] Vitamin D Toxicity […] Lead Poisoning […] Duodenal Atresia […] Anal stenosis […] Imperforate anus […] Small colon Syndrome

• #39 Table: Organic Causes of Constipation in Infants and Children-MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/multimedia/table/organic-causes-of-constipation-in-infants-and-children

  Absence of anal wink […] Plain radiographs of lumbosacral spine […] Spinal MRI […] Occult spina bifida […] Possibly sacral hair tuft or pit […] Tethered cord […] Change in gait […] Pain or weakness in lower extremities […] Urinary incontinence […] Back pain […] Spinal cord tumor or infection […] Back pain […] Pain or weakness in lower extremities […] Decrease in lower-extremity reflexes […] Change in gait […] Urinary incontinence […] Intestinal disorders […] Celiac disease (gluten enteropathy) […] Symptom onset after introduction of wheat into diet (typically after age 46 months) […] Growth and weight faltering (formerly known as failure to thrive) […] Recurrent abdominal pain […] Bloating […] Diarrhea or constipation […] Cow’s milk protein intolerance (milk protein allergy)

• #40 Assessing indicators and clinical differences between functional and organic childhood constipation: a retrospective study in pediatric gastroenterology clinics

  https://www.e-cep.org/journal/view.php?number=20125555624

  The organic causes of constipation are shown in Table 2. The overall organic causes were in order of neurological causes, allergies, endocrine, gastrointestinal, and genetic diseases. However, CMPA was specifically the commonest (n=35, 5.7%), followed by cerebral palsy (n=27, 4.4%) and hypothyroidism (n=15, 2.4%). […] Children with OC had higher percentage of associated diseases (n=120, 33.3%) than those with FC (n=35, 23.5%) which was statistically significant.

• #41

  https://www.beaumont.org/conditions/constipation

  Constipation is defined as: a decrease in frequency of bowel movements, compared to a child’s usual pattern (some physicians define constipation as fewer than three bowel movements per week). […] Sometimes, there is no identifiable reason for constipation in children. However, some of the causes may include: diet, lack of exercise, emotional issues, and busy children. […] Physical problems that can cause constipation include the following: abnormalities of the intestinal tract, rectum, or anus; problems of the nervous system, such as cerebral palsy; endocrine problems, such as hypothyroidism; certain medications (i.e., iron preparations and narcotics such as codeine). […] The symptoms of constipation may resemble other conditions or medical problems. Always consult your child’s physician for a diagnosis.

• #42 Chronic Constipation: Causes, Symptoms, Diagnosis and Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/chronic-constipation

  Chronic constipation can be caused by many factors, but one common trigger is when a child decides to hold in their bowel movements. […] If a child continues to ignore the bodys cues to go, their waste becomes hard and the rectum fills with stool and stretches. […] Children with behavioral issues like attention deficit hyperactivity disorder (ADHD) or developmental delays like autism can be at risk for developing chronic constipation. Chronic constipation can be further aggravated by a diet low in fluids or fiber.

• #43 Constipation in Children | Sutter Health

  https://www.sutterhealth.org/health/constipation-in-children

  Children at any age can have constipation from a tiny newborn to an active high schooler. In general, constipation in children causes hard-to-pass stool, which may or may not cause pain. […] Constipation is rarely seen in breastfed infants and more common in formula-fed babies, she says. […] Many babies get constipated due to being overstuffed with proteins, or from snacking on starches, such as crackers, pretzels and corn puffs, which are low in fiber and nutrition. […] One common cause of constipation in this age group is withholding, she says, which is when a child is afraid to go, either because of having a bad experience with a hard stool, or because we are trying to whisk them off to the potty while they are trying to pass a bowel movement. […] Dr. Brouard explains the lack of fiber is sometimes due to overconsumption of meat and starches, or they may be filling up on juices, sodas, sports drinks and sweets, and do not have an appetite to eat high-fiber foods as a result.

• #44 Constipation in babies – causes, signs and treatments | Pregnancy Birth and Baby

  https://www.pregnancybirthbaby.org.au/constipation-in-babies

  Constipation is when your baby’s stool (poo) is hard and dry, making it difficult for them to pass a poo. […] One of the main causes of constipation in babies is a change in diet. A change in diet may include: changing from being formula-fed, changing from being breastfed, exposure to new foods and flavours, not drinking enough liquids (breastmilk, formula or water). […] It is more common for bottle (infant formula) fed babies to have constipation than breastfed babies. […] If your baby has started eating solid food, a lack of fibre in their diet may also be a cause of constipation. Some babies simply have a natural tendency towards constipation, even when they have a good diet and drink enough fluids. This doesn’t mean they are unhealthy or unwell. […] In extreme cases, rare illnesses can cause constipation such as: problems with nerve endings in the bowel, problems relating to the spinal cord, thyroid deficiency, other metabolic disorders.

• #45 Evaluation and Treatment of Constipation in Children and Adolescents | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0715/p82.html

  Childhood constipation is common and almost always functional without an organic etiology. […] Outside of the neonatal period, childhood constipation is usually functional (i.e., there is no evidence of an organic condition). Functional constipation is most commonly caused by painful bowel movements that prompt the child to voluntarily withhold stool. […] The likelihood of an organic etiology for constipation is relatively greater in infants younger than six months, and particularly in those younger than three months.

• #46 Constipation and children | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation-and-children

  Constipation is the passing of a hard bowel motion (poo) with pain and discomfort. […] Common causes of constipation include lack of water and not enough fibre in the diet. […] The causes of a child’s constipation may not always be clear, but may include: If a child is drinking too much milk and not getting enough solids, the lack of fibre can cause constipation. […] A tear in the skin next to the anus (called an anal fissure) may be caused by doing a hard poo. This will make the child try to hold on for longer because it may hurt to go to the toilet. […] Some children ignore the urge to go to the toilet because they are too busy playing. […] Some children hold back when they are being toilet trained. […] Some children don’t want to use school or preschool toilets for various reasons, such as lack of privacy or a smelly toilet.

• #47 Constipation in Kids: Causes and Treatment – Children’s Health

  https://www.childrens.com/health-wellness/constipation-in-kids

  Does your child have fewer than two bowel movements a week, or have stool that is hard, dry, small and difficult to pass? If so, your child is probably suffering from constipation. A fairly common condition in children of all ages, about 5% of visits to pediatricians and 25% of visits to pediatric gastroenterologists are due to constipation. […] Rinarani Sanghavi, M.D., director of neurogastroenterology and GI motility at Childrens Health and associate professor of pediatrics at UT Southwestern, says the most common reason that children become constipated is related to diet. Children are not getting enough water or fiber from fresh, green, leafy vegetables, says Dr. Sanghavi. […] Another common reason Dr. Sanghavi cites is that kids are overscheduled and simply dont have enough time to sit on the toilet and try to poop. A small minority of children with constipation have a family history of the condition. Rarely, constipation is caused by a malformation in the nerves or muscles that control defecation.

• #47 Constipation in Kids: Causes and Treatment – Children’s Health

  https://www.childrens.com/health-wellness/constipation-in-kids

  If you have applied the three pillars and your child is still constipated, you should see a pediatrician. The first line of treatment is usually mild laxatives and further modification of diet, says Dr. Sanghavi. Although some parents might be concerned about the use of laxatives in children due to recent publicity about MiraLAX, Dr. Sanghavi says laxatives are generally safe and effective for treating constipation in kids. […] If more treatment is needed, your childs pediatrician will make a referral to a pediatric gastroenterologist for additional testing and treatment.

• #48 Understanding Constipation in Children: Causes & Treatment

  https://drgursev.com/constipation-in-children-causes-symptoms-and-treatment/

  Constipation in children is when bowel movements are infrequent or difficult to pass. […] Paediatric constipation is not the same as adult constipation because it usually results from behavioural habits, diet, or emotional stress rather than solely from medical conditions. […] Constipation in kids commonly develops because of their poor dietary habits, which are unhealthy. The combination of food low in fibre and high in dairy or processed ingredients can lead children to develop stiff stools. […] Modern sedentary lifestyles are a major cause of constipation in children. […] Sometimes, medical conditions such as hypothyroidism, Hirschsprungs disease, and neurological disorders can impact regular bowel operations and lead to constipation in children. […] Your child being emotionally unhappy can directly affect their digestive system functioning. […] Treating constipation in children early can prevent unnecessary discomfort and long-term health issues. Understanding the causes of constipation in children, identifying signs, and having effective treatments make it possible for parents to control their childs digestive system.

• #49 Constipation in children

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20198826

  Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract, causing the stool to become hard and dry. […] Many factors can contribute to constipation in children, including: […] Withholding. Your child may ignore the urge to have a bowel movement because he or she is afraid of the toilet or doesn’t want to take a break from play. […] Painful bowel movements caused by large, hard stools also may lead to withholding. […] Toilet training issues. If you begin toilet training too soon, your child may rebel and hold in stool. […] Changes in diet. Not enough fiber-rich fruits and vegetables or fluid in your child’s diet may cause constipation. […] Changes in routine. Any changes in your child’s routine such as travel, hot weather or stress can affect bowel function.

• #50

  https://www.capitalareapediatrics.com/blog/constipation-in-children-when-to-worry

  Constipation is a common problem among children, primarily occurring at the age of nine months and older. […] Common causes of constipation include: Toilet Training – If you begin toilet training too soon, your child may rebel and hold in the stool. […] Withholding – Your child may also try to avoid using the bathroom if they fear a bowel movement will hurt or if they don’t want to interrupt play. […] Dietary Choices – A lack of enough fiber-rich foods, vegetables, or fluid in your child’s diet may cause constipation. […] Changes in Routine – Any changes in your child’s routine, such as traveling on vacation, hot weather, and added stress can affect bowel function. […] Constipation is often a temporary problem, but if it is becoming recurrent, reach out to your child’s pediatrician. […] If constipation becomes chronic, complications may include: Painful breaks in the skin around the anus, known as anal fissures. […] Rectal prolapse, which is when the rectum comes out of the anus. […] Encopresis, which is accidental leakage of stool around impacted stool in the colon.

• #51 Constipation In Children – Causes, Prevention and Management

  https://www.icliniq.com/articles/parenting-and-childrens-health/constipation-in-children

  Constipation in children is often unrecognized and neglected by most. This article discusses the causes, symptoms, and treatment of constipation in children. […] Constipation in children is a common disorder. About 10-30% of patients attending pediatric gastroenterology OPD (Outpatient Department) have the disorder of fecal elimination. Constipation is a well-identified and easily noticeable disorder in adults. However, it is not so easy to identify in children due to their infrequent/irregular bowel movements. […] If this problem does not get attention at the earlier stages, it can lead to psychosocial disturbances in the child, decreased school performance, and growth failure. So, a simple disorder like this can lead to a devastating condition. […] A simple definition for constipation is „frequency of bowel movements less than 2 per week or passing of hard stools requiring excessive straining with or without the presence of blood in the stool.” Normal stool frequency in children is 4-5 times a day in infancy and 1-2 times daily in toddlers. Constipation in children with harder and tighter stools than normal. It occurs only if the gastrointestinal tract is damaged or infected.

• #52 About chronic intractable constipation | Children’s Wisconsin

  https://childrenswi.org/medical-care/gastroenterology-liver-and-nutrition-program/conditions/chronic-intractable-constipation

  This broad term describes a disorder where constipation symptoms do not respond to standard laxative therapy, dietary and lifestyle changes. […] Sometimes the problem stems from abnormally slow movement of food and stool inside the bowel (slow transit constipation) or poor coordination of stool expulsion effort (dyssynergia). Chronic intractable constipation can also be associated with conditions such as Hirshsprungs disease or anorectal malformations. […] Some patients may have an abnormality of the nerve and muscle lining of the bowel. Children with certain genetic syndromes, anorectal malformations, or a hereditary GI disorder such as Hirshsprungs disease are at risk of developing chronic intractable constipation. […] This condition often leads to severe pain. The buildup of stool can cause severe swelling and can increase the diameter of the colon to the point where it stops moving. […] Treatment usually begins with laxatives and stimulant medications to avoid the buildup of stool and soiling that can occur as a result of chronic constipation. […] If treated early and accurately and early, children tend to do well and have minimal consequences on their life.

• #53

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx?_gl=1

  Making sure that children drink enough water every day is crucial to many bodily functions. […] It is important to note that fiber supplements taken without enough water can worsen your child’s constipation! […] There are many laxative medicines available to treat children with functional constipation including stool softeners, osmotic laxatives, stimulant laxatives, secretagogue laxatives and rectal therapies. […] Constipation should be treated with maintenance medications for at least 2 months. After the 2-month period is completed, the child should be treated for at least 1 additional month while they are asymptomatic. […] In rare cases, children with functional constipation can undergo more testing to determine if the brain and nerves of the gut are working appropriately.

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