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Although the vast majority of children with constipation have no serious underlying pathology, the younger the child, the more likely it is that the problem is due to organic causes (physical disease).
It is particularly important to identify Hirschsprung’s disease. In this condition, present at birth, a segment of the bowel has no nerve supply and does not relax to allow the passage of stools. In the early months, diarrhoea, infrequent passage of stools or complete obstruction may occur. The child may be underweight and have a poor appetite. Abdominal distension is often present, and the rectum contains no faeces. Surgical removal of the abnormal segment gives excellent results.
Other disorders that can give rise to infant constipation include:
• Anorectal anomalies
• Cystic fibrosis
• Metabolic and endocrine disorders: hypothyroidism, hypercalcaemia, hypokalaemia
• Renal failure
• Lead poisoning
• Spinal cord lesion
• Cerebral palsy
