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Constipation likely cause in children
USA Today (Society for the Advancement of Education), Feb, 2008
The combination of acute and chronic constipation accounts for nearly half of all cases of abdominal pain in children, reports a study by the University of Iowa, Iowa City, suggesting that physicians should do a simple rectal examination for constipation when trying to determine the cause of abdominal pain in youngsters. Earlier research has shown that constipation can contribute to abdominal pain, but no specific recommendations for diagnosing this contributing factor were made, points out Vera Loening-Baucke, professor of pediatrics.
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"Constipation can be overlooked as the cause of severe or intermittent abdominal pain, as a reporting of symptoms alone does not always establish that a child has constipation. Our study helps to show that constipation frequently causes acute abdominal pain, and that a physician should not just ask the parent if the child is constipated because the parent may have not been able to see all the signs of this condition."
Constipation signs include fewer than three bowel movements or one or more episodes of stool incontinence per week, passing of stools so large that they obstruct the toilet, retentive posturing (withholding behavior), and painful defecation. "The doctor should perform an abdominal examination and a rectal examination to see if the child is retaining stool," notes Loening-Baucke.
She indicates that some physicians shy away from the rectal examination, which involves checking digitally for impacted stool in the lower colon, because they believe it may cause a child mental or physical discomfort. However, the test can be performed safely and explained to children so that they understand its purpose.
"It's important for doctors to do a thorough evaluation for abdominal pain, as there are many causes. In addition to constipation, having a cold or sore throat can also cause abdominal pain, for example," Loening-Baucke concludes.
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