Algorrhytm of diagnostic procedures and therapeutic approach to chronic constipation in

The high incidence of constipation among children can represent problems for the physician to decide about diagnostic procedures and therapeutic approach. Therefore, the Croatian society for pediatric gastroenterology, hepatology and nutrition recommends the following approach for the diagnosis and treatment of infants and children suffering of constipation. The approach is divided into procedures that should be performed by a pediatrician or family doctor, as well as procedures in the field of pediatric gastroenterology. The diagnostic procedures are: anamnesis and physical examination, including digital rectal examination. These first steps are sometimes sufficient for establishing the diagnosis of functional constipation. In other cases, laboratory analysis, radiological and manometrical examination and transit time analysis are performed. If constipation is confirmed, the first step is to remove the fecal retention. Dietary measures, behavior treatment and laxatives are measures for the prevention of reacummulation, which can take months. The goal of therapy is to achieve defecation on a regular basis without difficulty and fear and with no medication.