II. Indications

  1. Constipation in Children over age 1 year

III. Precautions

  1. Dietary recommendations in Pediatric Constipation have changed over time
    1. Current guidelines focus on increasing fiber and fluids (after disimpaction protocol)
  2. Prior recommendations limited diet, but without evidence
    1. Milk products were eliminated and replaced wth non-milk products
    2. Foods labeled as "constipating" were eliminated (e.g. apples, bananas, jello, carrots, rice)

IV. Management: General Measures

  1. Increase Dietary Fiber as below
  2. Avoid Caffeine
  3. Encourage salads
  4. Encourage increased fluid intake
    1. Age 1 to 3 years old: 4 cups per day
    2. Age 4 to 8 years old: 5 cups per day
    3. Age over 8 years old: 7 to 8 cups per day

V. Management: Dietary Fiber

  1. See Dietary Fiber
  2. General Fiber recommendations
    1. Increased fiber without adequate hydration may result in worsening Constipation (see fluid intake above)
    2. Unprocessed or minimally processed Dietary Fiber sources are preferred
    3. Give 14 g fiber per 1000 kcals (or at least 5 g/day + 1 g/ageY)
      1. Excess fiber above these levels does not improve Constipation
  3. Increase amount of bran in daily diet
    1. Unmilled bran or bran flakes
    2. Bran muffins
    3. Shredded wheat
    4. Graham crackers
    5. Oatmeal
    6. High fiber cookies
    7. Brown rice
    8. Whole wheat bread
    9. Cheerios
    10. Ralston or Wheetena
    11. Granola
  4. Add Bran flour to jelly, cereal, hamburger or casserole
    1. Child under age 6 years old: 2 heaping teaspoons
    2. Child over age 6 years old: 3 heaping teaspoons
  5. Encourage raw unpeeled fruits and vegetables tid
    1. Prunes, Figs, Dates, Raisins
    2. Peaches, Pears, Apricots
    3. Beans, Peas
    4. Celery
    5. Cauliflower, Broccoli, Cabbage

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Related Studies

Ontology: Constipation (C0009806)

Definition (CCC) Impression of infrequent or difficult passage of hard, dry feces without cause
Definition (CCC) Difficult passage of hard, dry, feces
Definition (MEDLINEPLUS)

Constipation means that a person has three or fewer bowel movements in a week. The stool can be hard and dry. Sometimes it is painful to pass. At one time or another, almost everyone gets constipated. In most cases, it lasts a short time and is not serious.

There are many things you can do to prevent constipation. They include

  • Eating more fruits, vegetables and grains, which are high in fiber
  • Drinking plenty of water and other liquids
  • Getting enough exercise
  • Taking time to have a bowel movement when you need to
  • Using laxatives only if your doctor says you should
  • Asking your doctor if medicines you take may cause constipation

It's not important that you have a bowel movement every day. If your bowel habits change, however, check with your doctor.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Definition (NCI) Irregular and infrequent or difficult evacuation of the bowels.
Definition (NCI_CTCAE) A disorder characterized by irregular and infrequent or difficult evacuation of the bowels.
Definition (NCI_NCI-GLOSS) A condition in which stool becomes hard, dry, and difficult to pass, and bowel movements don't happen very often. Other symptoms may include painful bowel movements, and feeling bloated, uncomfortable, and sluggish.
Definition (NAN) Self-diagnosis of constipation and abuse of laxatives, enemas, and suppositories to ensure a daily bowel movement
Definition (NAN) Decrease in normal frequency of defecation accompanied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool
Definition (CSP) condition in which bowel movements are infrequent or incomplete.
Definition (MSH) Infrequent or difficult evacuation of FECES. These symptoms are associated with a variety of causes, including low DIETARY FIBER intake, emotional or nervous disturbances, systemic and structural disorders, drug-induced aggravation, and infections.
Concepts Sign or Symptom (T184)
MSH D003248
ICD9 564.00, 564.0
ICD10 K59.0 , K59.00
SnomedCT 162080004, 363693003, 162083002, 197123003, 139356000, 139359007, 139358004, 162082007, 14760008, 129585003
LNC MTHU013416, MTHU013456, MTHU020768
French CONSTIPATION, Constipation
Portuguese Constipação Intestinal, OBSTIPACAO, Obstipação, Prisão de Ventre
Swedish Förstoppning
Japanese ベンピ, 便秘症, 便秘
Czech obstipace, zácpa, Zácpa
Spanish constipación subjetiva, constipación, SAI (trastorno), ESTRENIMIENTO, constipación, SAI, estreñimiento, SAI (hallazgo), estreñimiento, SAI, estreñimiento, SAI (trastorno), dificultad para evacuar el intestino, constipación (hallazgo), constipación, SAI (hallazgo), Constipation NOS, Constipación de Vientre, constipación, estreñimiento (trastorno), estreñimiento subjetivo (trastorno), estreñimiento subjetivo, estreñimiento, Estreñimiento
Finnish Ummetus
English constipation (diagnosis), constipation, constipation (symptom), Constipation NOS, Constipation, unspecified, Constipation [Disease/Finding], rndx unspecified constipation (diagnosis), rndx perceived constipation, rndx unspecified constipation, rndx perceived constipation (diagnosis), constipating, constipated, constipate, difficulty defecating, Constipation symptom, Constipation (& symptom), Constipation (& symptom) (finding), Constipation NOS (finding), Constipation (finding), Costive symptom, Constipation NOS (disorder), Unspecified constipation, CONSTIPATION, Perceived Constipation, Unspecified Constipation, Perceived constipation, Constipation (disorder), Costiveness, Perceived constipation (disorder), Difficult passing motion, Difficulty defaecating, Difficulty defecating, Difficulty opening bowels, Difficulty passing stool, CN - Constipation, Constipated, PERCEIVED CONSTIPATION, fecal; retention, retention; fecal, Constipation
German VERSTOPFUNG, Obstipation, Verstopfung
Korean 변비
Italian Costipazione, Stipsi
Polish Zaparcie
Hungarian Obstipatio
Norwegian Forstoppelse, Treg mage, Hard avføring, Obstipasjon
Dutch faeces; retentie, retentie; faeces, constipatie, Obstipatie, Constipatie