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Pathophysiology

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A number of features contribute to the cycle of events which result in childhood constipation. There are some pathologies which underlie the diagnosis, but in idiopathic or secondary constipation, the following occur:

  • with chronic loading of the rectum with hard stool, distension occurs
  • the distended or stretched rectum does not convey a feeling of fullness, and thus need to defaecate, in the same way that a normal rectum would
  • in the absence of sensation the rectum becomes more and more distended, and there is a tendency for stool to leak out unnoticed.

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