Organic Constipations: Red Flag Signs

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In children functional constipation is the major cause of constipation, however, 10 to 20% of cases are due to organic causes for which a clinician should watch for Red Flags:

Red flags suggestive of organic constipation: 

  • Delayed passage of meconium
  • Onset of constipation in early infancy
  • Failure to thrive
  • Ribbon or pellet stools
  • Bilious vomiting
  • Uniform abdominal distension
  • Recurrent lower respiratory tract infections
  • Neuro-developmental delay or regression
  • Gush of stools on digital rectal examination (DRE)
  • Anal malformations
  • Abnormal neurological examination (paraspinal, lower limbs and anorectal reflexes)

Organic causes of constipation

Hirschprung disease, hypothyroism, neurological and spinal causes, anatomical malformation , Chronic intestinal pseudo-obstruction, Celiac disease, lead poisoning, Slow transit constipation and Drug induced etc. 

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Post drafted on inputs from Dr Mridul Das, Ex-Pediatric Gastroenterologist at BLK Centre for Child Health

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