Leung A K, Chan P Y, Cho H Y
Alberta Children's Hospital, Calgary, Canada.
Am Fam Physician. 1996 Aug;54(2):611-8, 627.
Constipation is a common childhood condition, estimated to occur in 5 to 10 percent of children. In most cases, the cause is functional. However, constipation may occasionally indicate a significant organic disorder, which can usually be determined by a thorough history and physical examination. Constipation that is present from birth or that begins in the neonatal period is most likely to be congenital in origin. Acute constipation usually has an organic cause, while chronic constipation usually has a functional cause. Failure to thrive and gross distention of the abdomen suggest the diagnosis of Hirschsprung's disease. Rectal examination of a child with constipation usually reveals a distended rectum that is full of stool. In patients with Hirschsprung's disease, the rectum is usually empty and tight. Laboratory investigations are usually not necessary in patients with mild constipation. Treatment should be directed at the underlying cause. Functional constipation can be managed by changes in diet, regular bowel habits and, if necessary, pharmacologic therapy and biofeedback training.
便秘是一种常见的儿童疾病，据估计在5%至10%的儿童中发生。在大多数情况下，其病因是功能性的。然而，便秘偶尔也可能提示严重的器质性疾病，这通常可通过全面的病史和体格检查来确定。出生时即存在或在新生儿期开始的便秘最有可能是先天性的。急性便秘通常有器质性病因，而慢性便秘通常有功能性病因。生长发育迟缓及腹部明显膨隆提示先天性巨结肠的诊断。对便秘患儿进行直肠检查通常会发现直肠扩张且充满粪便。在先天性巨结肠患者中，直肠通常是空的且紧张。轻度便秘患者通常无需实验室检查。治疗应针对潜在病因。功能性便秘可通过饮食调整、规律排便习惯进行管理，必要时可采用药物治疗及生物反馈训练。
