infant dyschezia
Channel: JAM paeds
Date: 2021-01-05

Defecation requires two coordinated events: pelvic floor relaxation and an increase in intra-abdominal pressure. The coordination of the defecatory act carries with it developmental overtones and the failure to meet developmental milestones in the control of defecation results in functional symptoms.  Parents visit the clinician during the infant's first 2 to 3 months of life complaining that their child is "constipated". When asked to elaborate, parents anxiously describe a healthy infant who cries for 20 to 30 minutes, turns red in the face, and screams in pain before defecation takes place. The stools are soft and free of blood. These episodes, exhausting for the infant and anxiety provoking for the parents, occur several times daily. The diagnostic criteria for infant dyschezia are at least 10 minutes of straining and crying before successful passage of soft stools in an otherwise healthy infant less than six months of age.