© 2003 BMJ Publishing Group & Royal College of Paediatrics and Child Health
PAEDIATRIC LIAISON
Constipation
Containing anxiety in the management of constipation
1 PPALS, Berkshire Healthcare Trust, UK
2 Department of Paediatric Psychology, Oxford Radcliffe Hospital, UK
Correspondence to:
Correspondence to:
Dr A F West
Wokingham CAMHS, Wokingham Hospital Clinic Building, Barkham Rd, Wokingham RG41 2RE, UK; Andrew.West@berkshire.nhs.uk
A common problem
Keywords: infant constipation; child development; paediatric liaison; attachment
| The first 150 words of the full text of this article appear below. |
Childhood constipation is a common problem to which both paediatric and psychological perspectives can usefully be brought to bear. The case presented here is an extreme example and, as such, shows some of the pitfalls as well as providing a platform for the presentation of a way of understanding multidisciplinary intervention which might facilitate successful management, not only of childhood constipation, but in a broader clinical context.
A 5 year old boy was referred to a child mental health service with phobic avoidance of defecation and refusal to take medication or comply with Malone antegrade continence enemas (ACE).1 There was a long standing history of constipation predating the ACE procedure, but anticipated improvements after surgery had failed to materialise.
He was a wanted child, but the pregnancy was plagued with hyperemesis and fatigue. His mother, who had experienced problems breast feeding her children by an earlier marriage, bottle fed
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