Constipation

Abstract Constipation is common in children. In most, the cause will remain unclear and a pragmatic approach to bowel management is required. Most constipated children have anorectal retention, but dysmotility in the more proximal bowel is seen in some. Judicious use of investigations can demonstrate the transit pattern and allow a probable point of hold-up to be inferred. Treatment can then be directed more effectively. As constipation can lead to debilitating long-term symptoms, treatment-resistant patients are frequently referred for a surgical opinion, both to exclude a surgical cause and to consider surgical treatment options. Consequently, the paediatric surgeon must be able to deliver optimal medical management and be aware of the indications and role of surgery. This chapter outlines the key considerations that will influence decision-making.