Extensive investigations are rarely indicated. All investigations should be guided by the history and clinical findings. Table 3 lists the appropriate investigations for different conditions.
Table 3. Investigations For The Child With Constipation |
SIMPLE CONSTIPATION |
• None |
SEVERE CONSTIPATION WITH ENCOPRESIS |
• Flat plate x-ray of abdomen to assess fecal loading if results of abdominal examination are negative and rectum is empty |
• Routine urinalysis and urine culture |
CONSTIPATION AND FAILURE TO THRIVE |
• Thyroid function studies |
• Complete blood count |
• Erythrocyte sedimentation rate |
• Stool for occult blood and leukocytes |
CONSTIPATION AND URINARY TRACT INFECTIONS |
• Renal ultrasound |
• Voiding cystourethrogram |
SUSPECTED HIRSCHSPRUNG’S DISEASE |
• Barium enema: limited study of an unprepared bowel |
• Prompt referral to a pediatric surgeon for rectal suction biopsy and treatment |
He knows everything about medications – to which pharmacological group the drug belongs, what components are included in its composition, how it differs from its analogs, what indications, contraindications, and side effects remedy has. John is a real pro in his field, so he knows all these subtleties and wants to tell you about them.