Managing children with constipation: a community perspective.

Two clinical nurse specialists explain the nature of constipation in children and how the primary health care team can achieve successful treatment and management strategies for this condition. Constipation in children is a common and often complex problem. It may begin at four months of age in relation to weaning, or at around two years of age in relation to potty training. Constipation can be a distressing problem for the child and the family. Treatment failure rates are high, frequently reflecting poor understanding of the pathophysiology of constipation and inappropriate management. Symptoms include infrequent defaecation, pain and distress and refusal to defaecate. Causes include a poor intake of dietary fibre and fluid, emotional disturbances, possibly intercurrent infection and change in routine. Management of children with constipation includes an increase in dietary fibre and fluids, behaviour modification and laxative medication. For treatment to be effective there should be regular follow-up. Management of this chronic problem by nurses is viewed as effective and acceptable to parents.