ABSTRACT
Chronic constipation and faecal incontinence commonly present to general practitioners. They account for 5% of paediatric outpatients referrals, and make up 35% of the workload of a paediatric gastroenterologist. Constipation refers to the passage of infrequent hard stools causing distress to a child. However, the terminology can be confusing. The Paris Consensus on Childhood Constipation Terminology has therefore simplified the terminology defining the criteria for diagnosis. Recognised triggers that allow the constipation cycle to continue include difficulties with toilet training, school or home stresses, inter-current illnesses, avoidance of public toilets and/or hectic lifestyles. Once initiated, the constipation cycle is difficult to break. Anal fissures are commonly associated with constipation. Often the passage of a hard stool can cause a linear tear in the distal anal canal. There may be a history of painful defecation associated with bright red blood on the stool, in the nappy or on toilet paper.
