Constipation

Features in history

• since birth

  • delay in passing meconium

• difficulty in potty training

• overflow diarrhoea

Examination

• faecal loading

• "squirt" of faeces with rectal exam

Causes

• poor potty training

  • → retention → hard stools → anal fissure → pain

• Hirschsprung's disease

• Hypercalcaemia

• Hypothyroidism

• Chronic dehydration

  • diabetes

  • chronic renal failure

  • renal tubular disorders

• Anal stenosis

• Intestinal pseudo-obstruction

• Drugs - opiates

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