Rationale

Constipation is a common problem in children. It is important to differentiate functional from organic causes, recognizing that the vast majority of children do not have an organic cause for constipation.

Causal Conditions

(list not exhaustive)

1. Neonate and Infant

   1. Dietary

   2. Anatomic (e.g., Hirschsprung disease)

2. Older child

   1. Dietary

   2. Psychologic

   3. Anatomic (e.g., bowel obstruction)

   4. Neurologic

   5. Endocrine/metabolic

   6. Other (e.g., celiac disease, cystic fibrosis)

Key Objectives

Given a child who presents with constipation, the candidate will diagnose the cause, severity, and complications, and will initiate an appropriate management plan.

Enabling Objectives

Given a child who presents with constipation, the candidate will

1. list and interpret critical clinical findings, including

   1. clinical features that help to distinguish functional from organic;

   2. the social and psychological effects of chronic constipation;

2. list and interpret critical clinical investigations, including:

   1. the possibility that no investigation may be necessary;

3. construct an effective initial management plan, including

   1. initial and long-term therapy including laxatives, diet, and education;

   2. multidisciplinary approach as needed.