1. Functional constipation: 95%
• No organic cause is present but stay into adulthood despite adequate laxative treatment.
• Associated with lower urinary tract symptoms (LUTS) (30-50%)
• Faecal incontinence 2.9%
• Causes:
- Multifactorial e.g. food intolerance
- Withholding – painful experience
- Change in routine, toilet availability, illness, school changes and toilet access rules
- Genetic link
- Low socio-economic status
- Inadequate dietary intake
- Insufficient fluid intake
- Immobility
2. Organic constipation: 5%
• Hirschsprung disease
• Anorectal malformation
• Neuromuscular disease
• Metabolic endocrine disease
• Slow transit constipation- delay in transit time of gut caused by dysmotility of colon.
• Potentially due to:
- Reduced colonic pacemaker cells
- Dysfunctional enteric nervous system
- Reduced trunk control and posture