Paediatrics: Childhood Constipation: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Constipation in Children🎧 A clear, high-yield breakdown of this common paediatric bowel disorder – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• Functional constipation = infrequent, difficult or painful passage of stools in children, often associated with stool withholding and soiling.📌 Causes & Risk Factors• Functional (most common – >95%)• Organic (e.g. Hirschsprung’s, hypothyroidism, coeliac disease, spinal abnormalities)• Risk factors:Low fibre/fluid intakeSedentary lifestylePoor toilet habitsPsychological stressMedications (e.g. opioids, iron)🧠 Mnemonic: “5 F’s” – Fluid, Fibre, Fear (withholding), Faulty habits, Family history📌 Pathophysiology• Slowed colonic transit → prolonged water absorption → hard, dry stools• Painful defecation → fear → stool withholding → worsens cycle• Overflow soiling may occur (encopresis)📌 Symptoms• Infrequent stools (<3 per week)• Hard, painful stools• Withholding behaviour (e.g. tiptoeing, stiffening, hiding)• Abdominal pain, bloating• Faecal incontinence (overflow)• Reduced appetite, distress around toileting🧠 Mnemonic: “HIPPO” – Hard stools, Infrequent, Painful, Posturing, Overflow📌 Differential Diagnosis• Functional constipation• Hirschsprung’s disease• Anal fissure• Hypothyroidism• Spinal cord anomalies• Coeliac disease• Intestinal obstruction• Medication side effects📌 Diagnosis• Clinical history is key• Use Rome IV criteria for infants/children• Look for red flags (delayed meconium, abnormal anus position, neuro signs)• Investigations (if needed):TFTs, coeliac screen, calcium, sweat testAbdo X-ray or anorectal manometry if unclear🧠 Tip: Rectal exam and X-rays NOT routinely required for functional cases📌 Management• 1. Disimpaction with PEG (osmotic laxative)• 2. Maintenance therapy with regular laxatives (PEG ± stimulant if needed)• 3. Lifestyle changes:High fibre + fluid intakeBehavioural support (e.g. toilet routine, rewards)• 4. Long-term follow-up – wean laxatives slowly• Avoid stop-start treatment• Refer if: no response to 3 months’ treatment, suspected organic cause, safeguarding concerns📋 NICE CG99📌 Complications• Faecal impaction• Megacolon• Anal fissures• Rectal prolapse• Psychological distress• Chronic constipation and relapse📌 Prognosis• Most improve with early intervention and consistent management• Chronic cases more likely if delayed treatment or comorbidities (e.g. neurodevelopmental disorders)📎 More MSRA Resources for Constipation in Children📝 Revision Notes: https://www.passthemsra.com/topic/constipation-in-children-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/constipation-in-children-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/constipation-in-children-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/constipation-in-children-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/paediatrics-for-the-msra/#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQandANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #ConstipationInChildren