Go with the flow: in childhood constipation.

Childhood constipation is generally idiopathic and has a prevalence of five to 30 per cent. It can have significant implications on the quality of life for both the child and their family. Families may delay presentation as they may feel embarrassed or fear receiving a negative response from the healthcare professionals. Parents may report different symptoms as "constipation" depending on their own beliefs and previous experiences. A detailed history taken with the parents, along with a review of the Bristol Stool Form Scale chart will help in establishing a clinical diagnosis of constipation in the child. Suspicion of any "red flag" symptoms, such as delay in passage of meconium for greater than 48 hours after birth, toothpaste-like stool, etc, should initiate early referral to the paediatric services. Dietary intervention alone is not sufficient in treating constipation. Laxative therapy alongside dietary and lifestyle modifications will help manage constipation in the community. Health visitors in contact with the families concerned can help in early intervention, which is known to produce better outcomes.