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2005). Chronic childhood constipation is associated with impaired quality of life: a case controlled study. Journal of Pediatric Gastroenterology and Nutrition, Vol. 41, No. 1, pp. 56-60. 2 The Role of Diagnostic Tests in Constipation in Children Anthony G. Catto-Smith and Kathleen H. McGrath The Royal Children’s Hospital, Melbourne Australia 1. Introduction The diagnosis of constipation is usually suspected based on the presence of certain symptoms. These may include infrequent passage of stool, stools that are hard or difficult to pass or the presence of faecal incontinence.

These may include infrequent passage of stool, stools that are hard or difficult to pass or the presence of faecal incontinence. A careful clinical history and focussed physical examination are often all that is needed to confirm the diagnosis. There are a number of symptom-based classification tools that have been designed for diagnostic use in clinical practice. These classifications have evolved over time but there remains no universally accepted gold standard. The most recently published classification tool is the Rome III classification system.

Allergy testing (IgE antibodies to cow’s milk protein antigens) for cow’s milk protein allergy. This may be suspected in the context of constipation if the patient has a strong history of allergies, anal fissures / excoriation or abdominal discomfort. 14. Conclusion Most children with chronic constipation do not require any investigations other than a thorough history and physical examination. In patients with intractable constipation or red flags suggestive of an underlying organic aetiology, specialised testing may be indicated and of use.

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