Children - Constipation

Question 1

Symptoms

Answer 1

• Difficulty or straining when passing stools
• Passing stools less often than normal
• Difficult to pass
• Stools that are hard and perhaps very large

Question 2

Associated symptoms

Answer 2

• Tummy ache
• Poor appetite
• Behavioural changes, such as being more irritable or unhappy
• Fidgeting, restlessness and other signs that the child needs to go to the toilet
• Feeling sick (nausea)

Question 3

Red flag symptoms

Answer 3

• Severe abdominal pain
• Rectal bleeding or blood-stained stool
• Vomiting
• Severe pain on defaecation
• Persisting constipation despite increased dietary fibre, fluid intake/failed treatment with lactulose

Question 4

Idiopathic causes of constipatoin

Answer 4

• Common
• Various factors may be involved: diet, stool holding, emotional
• But can be for no known reason

Question 5

Constipation due to an underlying disease or condition

Answer 5

• Uncommon
• Some neurological conditions
• Hypothyroidism
• CF
• A side-effect of certain medications

Question 6

Treatment

Answer 6

• Osmotic laxative - Lactulose
• Bulk forming laxative - Fybogel Hi Fibre
• Dulocolac suppositories
  Continue medication at maintenance dose for several weeks after regular bowel habit is established

Question 7

Lactulose

Answer 7

• Takes 48 hours to work
• sweet tasting and suitable for long term use will only work if child drinks enough water or drink
• NOT SUITABLE FOR: diabetics, under 14

Question 8

Fybogel Hi fibre

Answer 8

• increased fibre is needed in your diet to relieve constipation
• Drink straight away, preferably after meals
• 6+

Question 9

Dulcolax suppositories

Answer 9

• 10-30 minutes
• SUITABLE FOR: 4 +
• CI: Diuretic, steroid med, other laxatives
• NOT SUITABLE: preg
• Should not be used everyday for more than 5 days

Question 10

Refer

Answer 10

Treatment failure
red flags