Hi, this is Tom and in this episode I'm going to be talking to you about constipation in children.

And you can find notes at zero to finals.com and in the zero to finals pediatrics book.

And you can find flashcards and questions to train your knowledge at members.com.

And at the end of this episode, we'll go through some questions so you can test yourself on what you just heard.

So let's jump straight in.

Constipation in children is a very common problem.

It features reduced stool frequency and harder

stools. Fecal impaction refers to when chronic constipation leads to a large build-up of hard

stools in the rectum and the bowel. This hard stool blocks the rectum and it stops the child from

being able to open their bowels. The only stalls that can get past this impaction are very

loose and tend to be very smelly. It can lead to overflow soiling, which is where loose, smelly stools end up leaking without the child

intending them to.

Let's go through the causes of constipation.

Idiopathic constipation, or functional constipation, is where there's no underlying physical cause other

than lifestyle and environmental factors. Contributing lifestyle and environmental factors include

reduced fluid intake, reduced fibre intake, reduced physical activity, and psychosocial issues such

as toilet training problems, stress or abuse. Key secondary causes to consider in children for

constipation include Hirshbrung's disease, where

part of the distal bowel and rectum is not innovated. Cistic fibrosis, which particularly causes

maconium ileus, which is a bowel obstruction by that very first stool after a newborn baby is born,

hypothyroidism or an underactive thyroid,

and medications such as antihistamines or opiates.

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