Therapeutic Management
Treatment of constipation depends on the cause and duration of symptoms. A complete history and physical examination are essential to determine appropriate management (Tobias, Mason, Lutkenhoff, et al, 2008). Meconium plugs are often evacuated after digital examination. It may be necessary to facilitate passage of the obstruction by irrigation with a hypertonic solution or water-soluble enema such as diatrizoate meglumine(Gastrografin) or diatrizoate sodium (Hypaque). If the constipation is due to HD, surgical treatment may include resection of the intestine and saline irrigations. Management of the infant should include education of the parents concerning normal bowel habits. Short, transient periods of constipation usually require no intervention. Mild constipation usually resolves as solid food is introduced in the diet. Stool softeners such as malt extract or lactulose may be used for hard stools or anal fissures. The persistent use of rectal stimulation with thermometers or cotton-tipped applicators is discouraged because these methods often result in anal fissures and increased pain that may trigger stool withholding.
Therapeutic Management Treatment of constipation depends on the cause and duration of symptoms. A complete history and physical examination are essential to determine appropriate management (Tobias, Mason, Lutkenhoff, et al, 2008). Meconium plugs are often evacuated after digital examination. It may be necessary to facilitate passage of the obstruction by irrigation with a hypertonic solution or water-soluble enema such as diatrizoate meglumine(Gastrografin) or diatrizoate sodium (Hypaque). If the constipation is due to HD, surgical treatment may include resection of the intestine and saline irrigations. Management of the infant should include education of the parents concerning normal bowel habits. Short, transient periods of constipation usually require no intervention. Mild constipation usually resolves as solid food is introduced in the diet. Stool softeners such as malt extract or lactulose may be used for hard stools or anal fissures. The persistent use of rectal stimulation with thermometers or cotton-tipped applicators is discouraged because these methods often result in anal fissures and increased pain that may trigger stool withholding.
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