Digital rectal examination in child with constipation

Digital rectal examination

• a digital rectal examination should be undertaken only by healthcare professionals competent to interpret features of anatomical abnormalities or Hirschsprung's disease
  
  
• if a child younger than 1 year has a diagnosis of idiopathic constipation that does not respond to optimum treatment within 4 weeks, refer them urgently to a healthcare professional competent to perform a digital rectal examination and interpret features of anatomical abnormalities or Hirschsprung's disease
  
  
• do not perform a digital rectal examination in children or young people older than 1 year with a 'red flag' in the history-taking and/or physical examination that might indicate an underlying disorder. Instead, refer them urgently to a healthcare professional competent to perform a digital rectal examination and interpret features of anatomical abnormalities or Hirschsprung's disease
  
  
• for a digital rectal examination ensure:
  • privacy
  • informed consent is given by the child or young person, or the parent or legal guardian if the child is not able to give it, and is documented
  • a chaperone is present
  • the child or young person's individual preferences about degree of body exposure and gender of the examiner are taken into account
  • all findings are documented.

Reference:

• 1) NICE (May 2010). Constipation in chidren