CLUES FROM HISTORY
Is constipation present since birth
- The commonest cause of organic constipation with onset usually in the neonatal period is congenital aganglionic megacolon. Present at birth with delayed passage of meconium. Other causes: anal stenosis, hypothyroidism
- Starts after the neonatal period usually in a child older than 18 months
Types of stools
- Stool of breastfed baby- golden yellow, loose in consistency (due to increased lactose content in human milk)
- Stool of a baby receiving top milk or formula milk is pale and firm in consistency. They tend to be constipated.
- Inadequate intake of fluids, cereals, vegetables and fruits ie. food with low fibre content can lead to constipation
- Pain associated with defecation: any painful condition in anorectal region can lead to constipation.
History of blood in stools:
History of neonatal jaundice and feeding difficulty:
- In a child with cretinism there would be a history of feeding difficulty and prolongation of jaundice
- Features of hypothyroidism, mental retardation