Objective: To analyze the etiology, clinical spectrum and outcome of constipation in children. Setting: Tertiary care teaching hospital. Design: Retrospective chart review. Participants: Consecutive children with constipation from 2011 to 2012 Inclusion criteria: Functional constipation was designated when there was no objective evidence of any causative pathologic condition while the rest were termed as organic constipation. Intervention: Lactulose was started after disimpaction with polyethyleneglycol in functional constipationcases. Outcome measures: Clinical and etiological profile, management, and follow-up data. Results: 137 children (boys, 90); 117 (85%), had functional constipation while the remaining 15% had an associated organic disorder. Hirschsprung’s disease accounted for 6% of all patients. Children in organic group more commonly had delayed passage of meconium (50.0% vs 1.7%), symptoms since first month of life (40.0% vs 1.7 %), and abdominal distension (50% vs 5%) as compared to functional group, while fecal impaction was less common (69% vs 20%). Besides fecal impaction, straining (35%), withholding behaviour (27.4%), and fecal incontinence (30.8%) were other main clinical characteristics of the functional group. In the functional group, ‘successful outcome’ to laxatives was obtained in 95% of patients while 10% needed rescue disimpaction. Conclusions: Functional constipation is the most common cause of constipation in Indian children. Historyof delayed passage of meconium, presence of abdominal distension, and absence of fecal impaction point toan organic pathology.

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