TABLE 5

Physical Examination of Children With Constipation

General appearance
Vital signs
 Temperature
 Pulse
 Respiratory rate
 Blood pressure
 Growth parameters
Head, ears, eyes, nose, throat
Neck
Cardiovascular
Lungs and chest
Abdomen
 Distension
 Palpable liver and spleen
 Palpable mass
Anal inspection
 Position
 Stool present around anus or on clothes
 Perianal erythema
 Skin tags
 Anal fissures
Rectal examination
 Anal wink
 Anal tone
 Fecal mass
 Presence of stool
 Consistency of stool
 Other masses
 Explosive stool on withdrawal of finger
 Occult blood in stool
Back and spine examination
 Dimple
 Tuft of hair
Neurologic examination
 Tone
 Strength
 Cremasteric reflex
 Deep tendon reflexes
  • Reprinted, with permission from Constipation Guidelines Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2006;43(3):e6.