Constipation — Cohort — Clinical Pathway: Emergency Department and Inpatient

Constipation Clinical Pathway — Emergency Department and Inpatient

Child with Features Supportive of Constipation

This pathway guides the evaluation and treatment of healthy children with functional constipation in the Emergency Department and the inpatient settings.

Functional Constipation Definition

Symptoms
  • Infrequent and/or painful defecation
  • Fecal incontinence
  • Abdominal pain
Diagnostic Criteria
of Constipation		 Symptoms present for at least 2 wks with 2 criteria present:
  1. ≤ 2 defecations per week
  2. At least 1 episode of incontinence/week after toilet trained
  3. History of excessive stool retention
  4. History of painful or hard bowel movements
  5. Presence of a large fecal mass in the rectum
  6. History of large-diameter stools that may obstruct the toilet
No Alternative Diagnosis

Exclusion Criteria

Underlying medical conditions include, but not limited to:

  • Cystic fibrosis
  • Congenital heart disease
  • Hirschsprung’s disease
  • Short bowel syndrome
  • Spina bifida
  • History of spinal or abdominal tumors
  • Known dysmotility syndromes
  • Currently undergoing chemotherapy or radiation
  • History of abdominal surgery