Constipation in Children

Constipation occurs in approximately 5% to 10% of children; it accounts for 3% of visits to the pediatric outpatient clinic and 25% of visits to a pediatric gastroenterologist. Defined as difficulty in passing stools; passing hard, dry, or unusually large stools; or infrequent defecation, constipation is sometimes associated with pain and a feeling of incomplete evacuation. The normal frequency of bowel movements has been characterized for infants and children as follows: Newborns have, on average, four stools per day the first week of life, with frequency decreasing to 1.7 and 1.2 stools per day around ages 2 and 4, respectively.

Diazepam. Interactions

Enhanced sedation or respiratory and cardiovascular depression may occur if diazepam or other benzodiazepines are given with other drugs that have CNS-depressant properties these include alcohol, antidepressants, sedative antihistamines, antipsychotics, general anaesthetics, other hypnotics or sedatives, and opioid analgesics. The sedative effect of benzodiazepines may also be enhanced by cisapride. Adverse effects may also be produced by use with drugs that interfere with the metabolism of benzodiazepines.

Diazepam. Uses. Preparations

Diazepam is readily and completely absorbed from the gastrointestinal tract, peak plasma concentrations occurring within about 30 to 90 minutes of oral doses. Diazepam is rapidly absorbed when given as a rectal solution peak plasma concentrations are achieved after about 10 to 30 minutes. Absorption may be erratic after intramuscular injection and lower peak plasma concentrations may be obtained compared with those after oral doses.

Theophylline. Interactions

The toxic effects of theophylline, aminophylline, and other xanthines are additive. Use with other xanthine medications should therefore be avoided if intravenous aminophylline is to be given for acute bronchospasm in patients who have been taking maintenance theophylline therapy, serum-theophylline concentrations should be measured first and the initial dose reduced as appropriate (see Uses and Administration, below).

Constipation Management

Constipation is a common problem experienced by many patients and can be caused by chemotherapy, radiation, surgery, stress, or medications. Please do not be afraid or embarrassed to call your doctor or nurse at any time; if left untreated the constipation may get worse and not improve on its own. Many chemotherapy and anti-nausea medications cause constipation, so when starting chemotherapy take a stool softener like Ducosate every day unless otherwise directed.

Response to Medications and Neurochemistry

Has there been any research done on individual responses to psychotropics as a predictor of their underlying neurochemistry? For example, when an individual is given Prozac and experiences extreme fatigue, can we use this information in a clinically relevant way? I’d appreciate your comments on this issue as well. I am not aware of any published research on this intriguing question, as you have phrased it, but perhaps I can point you in a useful direction.

SPECIALTY CARE

Specialty care for asthma can be confusing because each type of provider may have a different focus. Pediatric allergists specialize in the reactions of the immune system to common environmental allergens, such as pollens, dust mites, or pet dander, that can play a key role in asthma. Allergists use skin tests to detect allergies and may, in some cases, treat allergies by giving repeated small doses of the allergen.