Constipation in children- Assessment

What is constipation - currently the most widely accepted definitions for childhood functional constipation are the Rome III definitions. These are different based on age groups Functional constipation is an umbrella term that encompasses a group of disorders associated with persistent difficulty , infrequent or seemingly incomplete defecation without evidence of a structural or biochemical explanation (Manu R Sood , FRCPCH. MD ref 5 )

Age < 4 yrsNo organic pathology & 2 or more of the following for atleast 1 month-Two or < 2 defecations / week At least 1 episode of incontinence / week after the acquisition of toileting skills H/O excessive stool retention H/O painful or hard bowel movements Presence of a large faecal mass in the rectum H/O large-diameter stools that may obstruct the toilet

Age > 4 yrsInsufficient criteria for irritable bowel syndrome Criteria fulfilled atleast once/ week for atleast 2 months before diagnosis-Two or < 2 defaecations / week At least episode of fecal incontinence / week H/O retentive posturing or excessive volitional stool retention H/O painful or hard bowel movements Presence of large fecal mass in the rectum H/O large diameter stools that may obstruct the toilt

Abdominal pain is a frequent associated...