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Constipação em crianças

Last reviewed: 26 Mar 2025
Last updated: 09 Feb 2023

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • defecação difícil ou dolorosa
  • intervalos longos entre as defecações
  • incontinência fecal
  • incontinência fecal de pequeno volume e mole
  • massa fecal palpável no abdome
  • crianças saudáveis de um modo geral
Full details

Other diagnostic factors

  • dor abdominal
  • distensão abdominal
  • fissura anal
  • problemas vesicais associados
  • aparência anal anormal
Full details

Risk factors

  • dieta com baixo teor de fibras
  • dieta deficiente em nutrientes
  • predisposição genética
  • infecção
  • estresse
  • obesidade
  • baixo peso ao nascer
  • história psiquiátrica
  • deficiência física
  • treinamento esfincteriano inadequado
  • desregulação imune
  • baixa ingestão de líquidos
  • trauma
Full details

Diagnostic investigations

1st investigations to order

  • nenhum exame inicial
Full details

Investigations to consider

  • radiografia abdominal
  • estudo do trânsito colônico do marcador radiopaco
  • ultrassonografia abdominal
  • enema com contraste
  • biópsia retal por sucção
  • avaliação psicológica
Full details

Emerging tests

  • manometria anorretal
  • manometria colônica

Treatment algorithm

ACUTE

sem impactação: <1 ano de idade

sem impactação: ≥1 ano de idade

com impactação: <1 ano de idade

com impactação: 1 a 3 anos de idade

com impactação: ≥4 anos de idade

Contributors

Authors

Jaime Belkind-Gerson, MD, MSc

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.

Claire Zar-Kessler, MD

Instructor in Pediatric Gastroenterology

Massachusetts General Hospital for Children

Boston

MA

Disclosures

CZ-K has received support from Takeda for a clinical trial on prucalopride.

Acknowledgements

Dr Jaime Belkind-Gerson and Dr Claire Zar-Kessler would like to gratefully acknowledge Dr Corey Baker, Dr Wael El-Matary, Dr Steffen Reinsch, and Dr Meghan McPherson, the previous contributors to this topic.

Disclosures

CB, WE-M, SR, and MM declare that they have no competing interests.

Peer reviewers

David C.A. Candy, MBBS, MSc, MD, FRCP, FRCPCH, FCU

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.

Vikram Boolchand, MD

Gastroenterology Fellow

University of Arizona

Tucson

AZ

Disclosures

VB declares that he has no competing interests.

David J. Hackam, MD, PhD

Associate Professor of Pediatric Surgery

University of Pittsburgh School of Medicine

Pittsburgh

PA

Disclosures

DJH declares that he has no competing interests.

  • Differentials

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    • Anomalia anorretal
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