Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

J Pediatr Gastroenterol Nutr. 2006 Sep;43(3):e1-13. doi: 10.1097/01.mpg.0000233159.97667.c3.


Constipation, defined as a delay or difficulty in defecation, present for 2 or more weeks, is a common pediatric problem encountered by both primary and specialty medical providers. The Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) has formulated a clinical practice guideline for the management of pediatric constipation. The Constipation Guideline Committee, consisting of two primary care pediatricians, a clinical epidemiologist, and pediatric gastroenterologists, based its recommendations on an integration of a comprehensive and systematic review of the medical literature combined with expert opinion. Consensus was achieved through Nominal Group Technique, a structured quantitative method. The Committee developed two algorithms to assist with medical management, one for older infants and children and the second for infants less than 1 year of age. The guideline provides recommendations for management by the primary care provider, including evaluation, initial treatment, follow-up management, and indications for consultation by a specialist. The Constipation Guideline Committee also provided recommendations for management by the pediatric gastroenterologist.

Publication types

  • Practice Guideline

MeSH terms

  • Algorithms
  • Behavior Therapy
  • Cathartics / therapeutic use
  • Child, Preschool
  • Constipation / diagnosis
  • Constipation / etiology
  • Constipation / therapy*
  • Diagnosis, Differential
  • Fecal Impaction / prevention & control
  • Fecal Impaction / therapy
  • Gastroenterology
  • Gastrointestinal Transit
  • Hirschsprung Disease / complications
  • Hirschsprung Disease / diagnosis
  • Humans
  • Infant
  • Infant, Newborn
  • Medical History Taking
  • North America
  • Patient Education as Topic
  • Pediatrics
  • Physical Examination
  • Radiography, Abdominal
  • Recurrence


  • Cathartics