Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- difficult or painful defecation
- long interval between stools
- faecal incontinence
- small-volume, soft, incontinent stool
- palpable faecal mass per abdomen
- otherwise healthy child
Other diagnostic factors
- abdominal pain
- anal fissure
- associated bladder problems
- abnormal anal appearance
- abnormal neurological examination
Risk factors
- low-fibre diet
- poor-nutrient diet
- genetic predisposition
- infection
- stress
- obesity
- low birth weight
- psychiatric history
- immune dysregulation
- low fluid intake
- trauma
Diagnostic investigations
Treatment algorithm
Contributors
Authors
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.
Fellow in Pediatric Gastroenterology
Massachusetts General Hospital for Children
Boston
MA
Disclosures
CB declares that he has no competing interests.
Dr Jaime Belkind-Gerson, Dr Claire Zar-Kessler, and Dr Corey Baker would like to gratefully acknowledge Dr Wael El-Matary, Dr Steffen Reinsch, and Dr Meghan McPherson, the previous contributors to this topic. WE-M, SR, and MM declare that they have no competing interests.
Peer reviewers
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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