Constipation in children

Question 1

What is the Rome IV criteria

Answer 1

1. Infrequent defecation (less than twice/week)
2. History of excessive stool retention
3. Painful bowel movement
4. Rectal impaction / abdominal mass
5. Large stools which may obstruct toilet
6. Incontinence of stools at least once per week

Question 2

What is the Bristol Stool chart types

Answer 2

Type 1 Rabbit droppings
Type 2 Bunch of grapes
Type 3 Corn on the cob
Type 4 Sausage
Type 5 Chicken nuggets
Type 6 Porridge
Type 7 Gravy

Type 1-3: Constipation
Type 4,5: Normal
Type 6,7: Loose stools

Question 3

What should be done during a physical exam of a constipated child

Answer 3

General appearance
Abdomen
Anal inspection
Rectal examination
Back and spinal examination

Question 4

What are the special investigations for a constipated child

Answer 4

• Contrast enema
• Rectal biopsy
• Anorectal manometry
• Inpatient observation and evaluation
• Transit time

Question 5

What is the treatment for a child with constipation

Answer 5

Disimpaction
Adjust the diet
Faecal softeners when necessary
Good bowel habits
Education of parents/family
Regular follow-up and support