Waterham Michelle, Kaufman Jonathan, Gibb Susan
Aust Fam Physician. 2017 Dec;46(12):908-912.
Constipation is best defined as difficulty passing stools that may be infrequent (≤2 per week), painful and associated with stool retention. Childhood constipation is common, with a prevalence of 3-30% worldwide. Most constipation in children is functional and related to behavioural withholding after an unpleasant stool event. Successful diagnosis and management can occur in primary care, and specialist referral is only needed for refractory cases or concerns regarding organic pathology.
This article aims to provide a structure for evaluating, diagnosing and managing childhood functional constipation in general practice.
Structured history and examination can screen for organic pathology or red flags that require specialist referral. Investigations such as abdominal X-ray are not routine. Early management of childhood constipation provides improved quality of life for patients and their families. Management, including disimpaction and maintenance, should maintain continuity of care and provide long-term support for families.
便秘最好定义为排便困难，可能排便次数少（每周≤2次）、伴有疼痛且与粪便潴留有关。儿童便秘很常见，全球患病率为3%至30%。大多数儿童便秘是功能性的，与不愉快的排便事件后行为性憋便有关。在初级保健中可以成功进行诊断和管理，只有难治性病例或涉及器质性病变的情况才需要转诊至专科医生处。
本文旨在为全科医疗中评估、诊断和管理儿童功能性便秘提供一个框架。
结构化病史和体格检查可以筛查出需要转诊至专科医生处的器质性病变或警示信号。腹部X光等检查并非常规检查。儿童便秘的早期管理可改善患者及其家庭的生活质量。管理措施，包括解除粪便嵌塞和维持治疗，应保持护理的连续性，并为家庭提供长期支持。
