Constipation
Constipation may be defined as either the infrequent passage of motions or as difficulty with defaecation and the production of small hard stools. The frequency of defaecation varies widely in children, with some breast-fed babies passing only two to three stools per week, while other pass the same number each day. In childhood, constipation usually arises as a result of a mild feverish illness causing relative dehydration and a hard stool which the child finds difficulty in passing, which causes a painful graze of the anal canal. Similar problems arise in the schoolchild who dislikes the school lavatories. Not surprisingly the child does not want to repeat the experience, so ignores the next call to stool, which produces a vicious circle. It responds to increased fluid and medication to soften the stool, together with increased dietary fibre to stimulate the bowel. Schoolchildren may wish to capitalise on the normal post-breakfast reflex bowel contraction in the safety of their own homes (it might help to encourage them).
There are other, rarer causes - Hirschprung’s disease in the infant or Crohn’s disease in the adolescent (both described in this section) or spina bifida (described in the brain movement disorders in the head section) - which require different treatment.
|
