{"id":100,"date":"2017-03-23T07:48:57","date_gmt":"2017-03-23T07:48:08","guid":{"rendered":"http:\/\/papergp.com\/index.php\/constipation\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"constipation","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/paediatrics\/constipation\/","title":{"rendered":"Constipation"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Differential diagnosis<\/h4>\n<ul>\n<li>Hirschsprung&#8217;s, CF &#8211; meconium passed after 48hr<\/li>\n<li>Coeliac, Hypothyroid &#8211; faltering growth<\/li>\n<li>Fissure &#8211; anal pain, blood<\/li>\n<li>Overflow &#8211; loose, smelly stool, soiling<\/li>\n<li>UTI &#8211; dysuria<\/li>\n<li>Obstruction &#8211; abdominal pain, vomiting<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Red flags &#8211; see above<\/li>\n<li>Others &#8211; overflow soiling, anal pain, diet<\/li>\n<li>Examination &#8211; wt, height (centile), abdo, inspection of lumbo-sacral area + anus position<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical management<\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>Bloods &#8211; FBC, TFT, Calcium, Coeliac<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Explanation\n<ul>\n<li>usually normal, treatment can sometimes take months<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Treatment\n<ul>\n<li>Diet &#8211; high fibre, more fluid, less fizzy drinks<\/li>\n<li>Behaviour &#8211; scheduled toileting, reward system<\/li>\n<li>Medications\n<ul>\n<li>Lactulose\n<ul>\n<li>if &lt; 6 months old<\/li>\n<\/ul>\n<\/li>\n<li>Macrogol (Movicol Paediatric)\n<ul>\n<li>dose depends on age + disimpaction vs maintenance<\/li>\n<\/ul>\n<\/li>\n<li>Senna<\/li>\n<\/ul>\n<\/li>\n<li>PIL &#8211; ERIC\n<ul>\n<li><a href=\"https:\/\/www.eric.org.uk\/pdf-a-parents-guide-to-disimpaction\">Disimpaction guide<\/a><\/li>\n<li><a href=\"https:\/\/www.eric.org.uk\/pdf-breastfed-babies-and-constipation\">Breastfed babies and constipation<\/a><\/li>\n<li><a href=\"https:\/\/www.eric.org.uk\/pdf-how-to-prepare-macrogol-laxatives\">Preparing Macrogol Laxatives<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Follow-up \/ Safety net\n<ul>\n<li>Health visitor<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Differential diagnosis Hirschsprung&#8217;s, CF &#8211; meconium passed after 48hr Coeliac, Hypothyroid &#8211; faltering growth Fissure &#8211; anal pain, blood Overflow &#8211; loose, smelly stool, soiling UTI &#8211; dysuria Obstruction &#8211; abdominal pain, vomiting &nbsp; Data gathering Red flags &#8211; see above Others &#8211; overflow soiling, anal pain, diet Examination &#8211; wt, height (centile), abdo, inspection &hellip; <a href=\"https:\/\/papergp.com\/index.php\/paediatrics\/constipation\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Constipation<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":96,"menu_order":80,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-100","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/100","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=100"}],"version-history":[{"count":12,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/100\/revisions"}],"predecessor-version":[{"id":1954,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/100\/revisions\/1954"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/96"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=100"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}