Constipation
Einstein Health Glossary
ICD 10 - K590
What is constipation?
Commonly known as "bowel irregularity" or "constipation," it is diagnosed when children over the age of four present symptoms defined by the Rome IV Criteria at least once a week over a two-month period.
What are the Rome IV Criteria?
- two or fewer bowel movements per week
- one episode of fecal incontinence per week
- history of retentive posturing or excessive voluntary stool retention
- presence of a large fecal mass in the rectum
- history of large-diameter stools that may clog the toilet
- painful defecation
Causes
There are two main causes:
Functional constipation, which is the most common and is related to voluntary stool retention. And organic causes:
- metabolic disorders (hypothyroidism, cystic fibrosis, hypercalcemia, hypokalemia)
- neuropathic disorders (myelomeningocele, spina bifida, cerebral palsy, and Hirschsprung’s disease)
- immunological disorders (cow’s milk protein allergy, celiac disease)
- constipation due to opioid use
Complications
Constipation affects a child’s emotional well-being and socialization. It may also lead to physical complications such as: recurrent abdominal pain, fecal incontinence, rectal bleeding, enuresis, and urinary infection/retention.
Treatment
Treatment includes guidance on dietary habits, use of fiber supplements, toilet training, pharmacological approach, fecal disimpaction, and physical therapy with pelvic floor muscle relaxation training through electromyographic biofeedback.
If symptoms do not improve with clinical treatments, surgical intervention may be considered.