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Constipation, Pediatric

Jay Fong, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Delay or difficulty in defecation; infrequent (<2) stools per week; defecation resulting in pain and/or rectal bleeding, and/or fecal soiling; may also refer to a decrease in freq...

DIAGNOSIS

HISTORY

  • Question: What was the timing after birth of passage of meconium?

  • Significance: If it is delayed for >48 hours, consider Hirschsprung disease.

  • Question: Is the child able to pass a b...

TREATMENT

GENERAL MEASURES

  • Treatment of functional constipation:

    • Disimpaction

      • The use of polyethylene glycol (PEG) (e.g., MiraLAX® or other generics) with or without electrolytes orally at 1 to 1.5 g/kg/...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Schedule regular visits to make certain therapy is maintained, decreasing the frequency of visits when patient is doing well.

  • Parents should be encouraged to call ...

ADDITIONAL READING

  • Bekkali NLH, van den Berg MM, Dijkgraaf MGW, et al. Rectal fecal impaction treatment in childhood constipation: enemas versus high doses oral PEG. Pediatrics.  2009;124(6):e110...

CODES

ICD9

  • 564.00 Constipation, unspecified

  • 564.09 Other constipation

  • 564.02 Outlet dysfunction constipation

ICD10

  • K59.00 Constipation, unspecified

  • K59.09 Other constipation

  • K59.02 Outlet dysfunction constip...

FAQ

  • Q: When is constipation an emergency?

  • A: When intestinal obstruction, sigmoid volvulus, or Hirschsprung enterocolitis occurs.

  • Q: Does polyethylene glycol-3350 taste bad?

  • A: Advantages of polyethylene...

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