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Managing functional constipation in childhood

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Functional constipation is a common problem in childhood and is responsible for up to 95 per cent of all defaecation problems in children. In the majority of cases the constipation develops as a result of a complex mesh of factors often precipitated by the passage of a large painful stool. The management of constipation can often be a challenge in children who may be reluctant to sit on the toilet.

Constipation affects up to 37 per cent of children and is responsible for up to 95 per cent of all bowel problems.1

In most cases, the constipation is exacerbated by the passage of a large hard stool, which perpetuates the problem as the child begins to associate pain with the opening of his or her bowels and 'holds on' as a result. Early assessment and appropriate treatment of constipation is therefore essential to prevent the constipation becoming entrenched.

The NICE childhood constipation guidance2 provides recommendations based on the best available evidence to support early identification, positive diagnosis and timely, effective management of constipation in children. Implementation of this guidance in practice will provide a consistent, co-ordinated approach to care delivery and will improve outcomes for children.

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