Hildhood Constipation: A Global Problem and its Management Guideline

Abstract

Introduction: Background: Constipation is a symptom, not a disease, every person in this world experiences constipation at some point in their real life. However, the prevalence of constipation in childhood is more but it is still under-appreciated in paediatric age group. Considering childhood constipation being one of the underappreciated and mismanaged health problems, the faculty members of paediatric surgery department, BSMMU approved a consensus of guideline of management of childhood constipation. It thus assists health care workers in the management of all of the children with constipation in all the level of care i.e. primary, secondary, and tertiary care. Methods: The faculty members of paediatric surgery department of BSMMU addressed the problem of constipation in infants and children who had no previously established medical condition. To develop the initial evidence-based guideline, articles on constipation published in English were found using Medline, Embase and Cochrane Database of Systematic Reviews. Result: The guidelines provide recommendations for the diagnostic evaluation of children presenting with constipation and treatment of children with functional constipation to standardize and improve their quality of care. In this study, two guidelines were developed, the first guideline for the evaluation and treatment of infants <6 months. The second guideline is for the evaluation and treatment of children > 6 months of age. Conclusion: Constipation is globally underappreciated problem and should be evaluated thoroughly. Constipation due to functional or organic cause should be identified. Management protocol should be adapted as per the guideline shown in fig. 1 and fig. 2. Emphasis should be laid on toilet-training, feeding habit and importantly in counselling particularly related to long term usage of medical therapy.