Diagnosis of Constipation in Children

Constipation is a frequent reason for consulting a pediatrician. As a symptom, constipation can be due to various etiologies in terms of frequency, nature and seriousness. Constipation may be of medical or surgical origin or idiopathic. Surgical etiologies are mainly represented by Hirschsprung’s disease. It is the main differential diagnosis even if it is 50 times less frequent than idiopathic or functional constipation. A thorough history and physical examination, including anal examination, are the best way to reach a diagnosis. No other examination is required in most of the cases and all investigations have to be managed according to clinical considerations. Copyright © 2007 Nestec Ltd., Vevey/S. Karger AG, Basel Constipation is the reason for consulting a pediatrician in 3% of the cases and a gastroenterologist in more than 25% [1, 2] . The first difficulty with regard to constipation is to define the normal number of stools a child should have. Indeed this varies according to age and the type of food. Constipation can be defined by a frequency of spontaneous stools of less than 3/week. It can be accompanied by other signs (abdominal pains) that are Dr. F. Sauvat Pediatric Surgery, Hôpital Necker-Enfants Malades 149, rue de Sèvres FR–75015 Paris (France) Tel. +33 1 44 49 41 54, Fax +33 1 44 49 42 00, E-Mail [email protected] © 2007 Nestec Ltd., Vevey/S. Karger AG, Basel 0517–8606/07/0652–0063$23.50/0 Accessible online at: www.karger.com/ane D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /1 3/ 20 17 3 :4 7: 02 P M