Loening-Baucke V
University of Iowa College of Medicine, Iowa City.
Am Fam Physician. 1994 Feb 1;49(2):397-400, 403-6, 411-3.
Infants and toddlers with constipation usually have a history of infrequent, hard and painful bowel movements, often accompanied by screaming and stool-holding maneuvers. Encopresis, the intermittent and involuntary passage of formed-to-liquid feces, is common. Although constipation most often has a functional cause, the history and physical examination should rule out anatomic, endocrinologic, metabolic or neurologic causes. Hirschsprung's disease--aganglionic megacolon--is a congenital cause of severe constipation that occurs in one of every 5,000 births. Treatment consists of fecal disimpaction, laxatives to prevent future impaction, promotion of regular bowel habits and, finally, toilet training. Parents should be reassured that although this disorder is not life-threatening, several months to years of supportive intervention may be required for effective treatment.
患有便秘的婴幼儿通常有排便不频繁、大便干结且排便疼痛的病史，常伴有哭闹和憋便动作。大便失禁，即成形便或稀便间歇性不自主排出，很常见。虽然便秘最常见的原因是功能性的，但病史和体格检查应排除解剖学、内分泌、代谢或神经学原因。先天性巨结肠病是严重便秘的一种先天性病因，每5000例出生中就有1例发生。治疗包括清除粪块嵌塞、使用泻药预防未来的嵌塞、培养规律的排便习惯，最后是进行排便训练。应让家长放心，虽然这种疾病不会危及生命，但可能需要数月至数年的支持性干预才能有效治疗。
