ABSTRACT
This chapter outlines a case scenario on chronic constipation followed by a highly detailed explanation of the condition and its management, presenting the symptoms in a way that are likely to be encountered in general practice. Constipation is present when the passage of stool is associated with either pain/difficulty. The estimated prevalence is around 5%–30% in childhood. The child stops feeling the normal contractions of the bowel, reducing his or her urge to defecate. This further hardens and enlarges the faecal mass in the distal bowel, leading to worsening constipation. Laxative use at this stage may result in looser stool ‘bypassing’ the hard faecal mass and causing troublesome soiling. Explanation that fear of pain forces the child to contract the anal sphincter, thereby preventing passage of the faecal mass, may help in better management of the problem. The child should be encouraged to sit on the toilet daily. The purpose of laxative therapy is to maintain a regular bowel habit.
