Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • difficult or painful defecation
  • long interval between stools
  • fecal incontinence
  • small-volume, soft, incontinent stool
  • palpable fecal mass per abdomen
  • otherwise healthy child

Other diagnostic factors

  • abdominal pain
  • anal fissure
  • associated bladder problems
  • abnormal anal appearance
  • abnormal neurologic exam

Risk factors

  • low-fiber diet
  • poor-nutrient diet
  • genetic predisposition
  • infection
  • stress
  • obesity
  • low birth weight
  • psychiatric history
  • immune dysregulation
  • low fluid intake
  • trauma

Diagnostic investigations

Investigations to consider

  • abdominal radiograph
  • radiopaque marker colonic transit study
  • abdominal ultrasound
  • pelvic ultrasound
  • rectal mucosal biopsy
  • psychological assessment
Full details

Emerging tests

  • endoanal sonography
  • anorectal manometry
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Director Neurogastroenterology and Motility Program

Digestive Health Institute

Children's Hospital Colorado

Associate Professor of Pediatrics

University of Colorado School of Medicine

Colorado

CO

Disclosures

JB-G declares that he has no competing interests.

Instructor in Pediatric Gastroenterology

Massachusetts General Hospital for Children

Boston

MA

Disclosures

CZ-K has been reimbursed by Genzyme for speaking at several conferences.

Dr Jaime Belkind-Gerson and Dr Claire Zar-Kessler would like to gratefully acknowledge Dr Wael El-Matary, Dr Steffen Reinsch, and Dr Meghan McPherson, the previous contributors to this monograph. WE-M, SR, and MM declare that they have no competing interests.

Peer reviewers VIEW ALL

Consultant Paediatric Gastroenterologist

Royal West Sussex NHS Trust

Chichester

UK

Disclosures

DCAC has served as a consultant to, and spoken at symposia sponsored by, Norgine Ltd.

Gastroenterology Fellow

University of Arizona

Tucson

AZ

Disclosures

VB declares that he has no competing interests.

Associate Professor of Pediatric Surgery

University of Pittsburgh School of Medicine

Pittsburgh

PA

Disclosures

DJH declares that he has no competing interests.

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