Constipation

Chronic constipation in children is occasionally organic, but in most cases no organic cause has been found. Using gastrointestinal scintigraphy, we have shown that children with intractable constipation have slow transit in the colon, but some have rapid transit in the proximal colon with anorectal retention. Rapid transit (i.e., occult diarrhea) is often secondary to food intolerance, so we tested whether children with chronic constipation may have a form of irritable bowel syndrome and found many have abnormal breath hydrogen tests with malabsorption of fructose, lactose, or other sugars. Most importantly, we now recognize that in most children with chronic constipation the symptoms resolve with an exclusion diet of the sugar(s) identified by hydrogen/methane breath tests.