Constipation - habitual - When?

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1. 3 stools per week
2. At least 2 episodes of soiling
3. Passage of large hard stools at least once every 7-30 days
4. Hard masses of stools felt on examination

Habitual constipation - Why does it happen?

1. Poor diet
2. Inadequate fibre in the diet- fruit, vegetable & cereals
3. Too little fluids
4. Too much milk
5. Medications
6. Inactivity
7. Unpleasant facilities
8. Emotional stress
9. Rarely a serious underlying cause

Constipation - habitual - When?

1. Constipation since birth
2. Onset < 1 year of age
3. Failure to thrive
4. Constipation with big protuberant tummy
5. Constipation alternating with diarrhoea
6. Intractable no response to medications