El estreñimiento es un trastorno extremadamente frecuente en la infancia, responsable de hasta el 25% de todas las consultas gastroenterológicas pediátricas y el 3% de todas las consultas pediátricas ambulatorias. En el 90% de los casos el origen del trastorno es funcional y sólo en un 10% existe un problema orgánico subyacente. Entre las causas orgánicas corrientes del estreñimiento infantil destacan las siguientes: malformaciones congénitas del intestino; patología neurológica, especialmente parálisis cerebral; trastornos de la médula espinal e hipotonía; trastornos endocrinos y metabólicos (hipotiroidismo, fibrosis quística, hipercalcemia, diabetes mellitus, acidosis renal) y el uso de fármacos astringentes, como algunos antiácidos, sucralfato, hierro, medicamentos que contienen codeína, imipramina, fenitoína, etc. El más frecuente de los trastornos congénitos es la enfermedad de Hirschsprung, que presenta una incidencia de 1 caso de cada 4.500 nacimientos vivos en comparación con 1 caso de cada 7.000 nacimientos vivos con malformaciones anorrectales y 1 caso de cada 40.000 con otros trastornos neuromusculares entéricos. Menos del 5% de los niños que acuden por primera vez con estreñimiento presenta una enfermedad orgánica demostrable.

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