II. General

  1. Constipation has functional cause in >95% of infants

III. Constipation Causes: Organic

  1. Neurologic Causes
    1. Hirschprung's Disease
      1. Consider if no meconium stool by 48 hours old
    2. Spinal Dysraphism (Myelomeningocele, Spina bifida)
    3. Encephalopathy
  2. Endocrine Causes
    1. Hypothyroidism
    2. Hypokalemia
    3. Diabetes Insipidus
    4. Hypercalcemia
  3. Miscellaneous causes
    1. Congenital Anorectal malformation
    2. Heavy-metal Poisoning
    3. Cystic Fibrosis

IV. Failure to Pass Meconium Causes (first 24-48 hours)

  1. Meconium Plug Syndrome (1-2 in 1000)
  2. Cystic Fibrosis (1 in 2800)
  3. Hirschsprung's Disease (1 in 5000)
  4. Anorectal Malformation (1-2 in 8000)
  5. Other rare disorders
    1. Hypoganglionosis
    2. Small left colon syndrome

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