In children functional constipation is the major cause of constipation.
However, 10 to 20% of cases are due to organic causes.
Organic causes of constipation:
Hirschprung disease, hypothyroism, neurological and spinal causes, anatomical malformation , Chronic intestinal pseudo-obstruction, Celiac disease, lead poisoning, Slow transit constipation and Drug induced etc.
Red flags suggestive of organic constipation:
Delayed passage of meconium
Onset of constipation in early infancy,
Failure to thrive
Ribbon or pellet stools
Uniform abdominal distension
Recurrent lower respiratory tract infections
Neuro-developmental delay or regression
Gush of stools on digital rectal examination (DRE)
Abnormal neurological examination (paraspinal, lower limbs and anorectal reflexes)
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