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Constipation is defined as infrequent and difficult passage of hard, dried stools and the problem generally involves gastrointestinal tract and individual psychological attitude.

All ages are affected, but more frequent at the extremes of life (infancy and old age).

In the age group of 1-5 years, boys are affected more than girls, whereas in adults females get affected more than males.

Signs & Symptons


  • Lesser frequency of passing stools, which may be perceived as normal.
  • Evacuation of a lesser volume of stools.
  • A lack of consistent urgency to pass stool.
  • Difficulty in expelling stools from the rectum.
  • Painful evacuation of stools.
  • A lingering sense of incomplete emptying.
  • A vague feeling of malaise including lower abdominal fullness, lack of appetite and gaseousness.


  • Impaction of dry stools in rectum.
  • On Per rectal by a physician, tight stricture or a lump may be felt.
  • Furred or coated tongue may be present.
  • Child may lack energy or enthusiasm.


Common causes:

  • Faulty feeding habits or inadequate toilet training is the commonest cause.
  • Inadequate fluid or fibre intake
  • Hypothyroidism (quite common)

Rare causes:

  • Certain congenital Abnormalities
  • Mechanical bowel obstruction
  • Painful evacuation from conditions like anal fissures
  • Rarer causes are Cretinism, Mongolism, Mental Retardation.


If there is a tendency to constipation, instruction for proper diet, toilet training and use of bulk-forming supplements must be re-inforced from time to time.

Diagnostic Measures

Its important that FUNCTIONAL disorders are distinguished from ORGANIC lesion by proper history taking and Digital Examination of the anus

Possible Complications

  • In severe long-standing cases – Acquired Megacolon.
  • With Laxative Abuse – Fluid and Electrolyte imbalance

Surgical Measure

  • Mechanical Obstruction e.g. impacted stools – Digital Removal.
  • Anal Fissure – Advise regarding non-straining and dilatation if required

Probable Outcomes

It depends on proper diagnosis and adequate treatment and most important is patient’s compliance. Understanding the significance of high fibre diet, exercise and immediate answer to defecation call is very important.


General Measures

  • High fiber diet like regular use of spinach, papaya and fiber enriched cereals foods containing roughage e.g. green vegetables, salads or lettuce, radish, cabbage, tomatoes, cooked vegetables and fruits, stewed dried fruits, prunes, figs and apricots.
  • Increased intake of water.
  • Infants who are constipated, generally benefit from fig syrup or chopped dried figs given in milk.


Laxatives and Enemas should only be used with Doctor’s advise. Glycerin suppositories which can be used by the patient are often useful. Bulk laxatives (like Isapgol) should be tried first.

Dietary Restrictions

  • Avoid white flour (Maida etc) and refined foods.
  • Over usage of laxatives and drugs.

Contact your Doctor

  • If constipation associated with vomiting or distress.
  • If no relief with regular laxatives and high fibre diet.