Constipation

Priority concept: Preventing fecal impaction, recognizing red flags, supporting safe bowel routines 1. Overview Constipation is a common pediatric GI concern. It usually means the child is passing stool less often than expected, having hard or painful stools, straining, withholding stool, or having stool leakage from overflow. Pediatric constipation may present as fewer than 3 complete stools per week, hard pellet-like stools, abdominal discomfort, stool-withholding behaviours, fecal incontinence, or watery stool due to overflow around impacted stool. Most childhood constipation is functional, meaning there is no structural disease causing it. However, RPNs must recognize red flags that may suggest Hirschsprung disease, bowel obstruction, spinal/neurologic abnormality, endocrine/metabolic concerns, abuse/trauma, or another serious condition. NICE guidance emphasizes that red flags should trigger urgent referral rather than routine constipation management. 2. RPN Learning Objectives By the end of this lesson, the learner should be able to: Describe common causes of pediatric constipation. Identify expected and concerning assessment findings. Recognize red flags that require escalation. Provide safe RPN-level interventions and family teaching. Differentiate constipation, fecal impaction, and bowel obstruction. Support bowel routines using developmentally...