• Linda Nicolette


Constipation is defined as a stool frequency of less than 3 times per week. These patients will have bulky, hard, dry bowel movements that can be painful to pass. The age range for this diagnosis can obviously be from a newborn infant to an older child, though the most common age of presentation is between 1 and 5 years. The work up and management is often dependent on the age of the patient. Most children with constipation are well managed by pediatricians and pediatric gastroenterologists. The patients that are referred to the pediatric surgeon are often those who rarely or never have bowel movements without some mechanical assistance, either orally or per rectum. They may have had difficulty since birth or gradually developed worsening constipation as they transitioned off breast milk or formula and onto cow’s milk. Sometimes they will have a diagnosis that might indicate the possibility of a functional disorder of the colon, such as gastroschisis, Hirschsprung disease or cystic fibrosis. Rectal sphincter disorders, such as imperforate anus, cloacal anomalies and myelomeningocele also contribute to constipation issues. There are children who have conditions such as trisomy 21 and cerebral palsy and who are more likely to be constipated. Finally, children with complex neuromuscular disorders (muscular dystrophy, spinal muscular atrophy, intestinal pseudo-obstruction), might require surgical assistance with the problems of constipation.


Cerebral Palsy Spinal Muscular Atrophy Anal Fissure Contrast Enema Imperforate Anus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. Bani-Hani AH, Cain MP, Kaefer M, et al. The Malone antegrade continence enema: single institution review. J Urol. 2008;180: 1106–10.CrossRefPubMedGoogle Scholar
  2. Barqawi A, De Valdenebro M, Furness III PD, Koyle MA. Lessons learned from stomal complications in children with cutaneous catheterizable continent stoma. BJU Int. 2004;94:1344–7.CrossRefPubMedGoogle Scholar
  3. Herndon CDA, Cain MP, Casale AJ, Rink RC. The colon flap/extension malone antegrade continence enema: an altenative to the monti-malone antigrade continence enema: an alternative to the monti-malone antegrade continence enema. J Urol. 2005;174: 299–320.CrossRefPubMedGoogle Scholar
  4. Kajbafzadeh AM, Chubak N. Simultaneous malone antegrade continent enema and mitrofanoff principle using the divided appendix: report of a new technique for prevention of stoma complications. J Urol. 2001;165:2404–9.CrossRefPubMedGoogle Scholar
  5. Ransley PG. The ‘VQZ’ plasty for catherizable stomas. In: Frank DJ, Gearhart JP, Snyder III HM, editors. Operative pediatric urology. 2nd ed. London: Churchill Livingstone; 2002. p. 111–4.Google Scholar
  6. Rintal RJ, Pakarinen M. Other disorders of the anus and rectum, anorectal function. In: Grosfeld JL, O’Neill JA, Fonkalsrud EW, Coran AG, editors. Pediatric surgery. 6th ed. Philadelphia: Mosby; 2006. p. 1590–5.Google Scholar
  7. Voskuijl W, de Lorijn F, Verwijs W, et al. PEG 3350 (Transipeg) versus lactulose in the treatment of chronic functional constipation: a double blind, randomixed, controlled trial. Gut. 2004;53(11): 1590–4.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryPresbyterian HospitalAlbuquerqueUSA

Personalised recommendations