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Chronic Constipation Clinic

The Division of Pediatric Gastroenterology and Nutrition has partnered with Pediatric Medical Psychology to offer a specialized clinic for children and teenagers suffering from chronic constipation. Working together, Lisa Santo Domingo, M.S.N., R.N., C.P.N.P., and behavioral psychologist Jessica Hankinson, PhD, offer state-of-the-art evaluation and treatment for both the medical and behavioral considerations involved in chronic constipation. Studies show that combined medical and behavioral intervention consisting of initial clean-out, dietary education, goal-setting, a sitting schedule and reinforcement yield positive outcomes for constipation and fecal incontinence. 

Does my child have chronic constipation?

Constipation refers to a condition in which an individual has few bowel movements or experiences bowel movements with hard or dry stools that are difficult to pass. Signs of chronic constipation include:

  • Having irregular stools or stools that are difficult to pass
  • Toilet trained but having stool incontinence (stool accidents)
  • Having painful bowel movements
  • Failure to respond to the initial constipation treatment plan
  • Avoiding or refusing to have bowel movements
  • Encopresis, or the uncontrolled leaking of stool into the underwear. 

Please know that some children can have a bowel movement every day and still have stool accidents or encopresis if they do not totally empty when defecating. This may be a sign of chronic constipation.

What will the clinic do to help?

Research indicates the most effective management of constipation includes both medical and behavioral treatments. Treatment at the Chronic Constipation Clinic may include the following, depending upon your child's specific needs:

  • Family education
  • Clean-out procedures (e.g., enemas and oral laxatives)
  • Maintenance medications
  • Diet modifications 
  • Assistance developing a behavioral plan tailored to your child and family
  • Training in behavioral strategies to increase your child's cooperation
  • Cognitive-behavioral therapy targeting anxiety associated with toileting/bowel movements

How do I make an appointment?

  • Call 410-955-8769 to schedule an appointment with Lisa Santo Domingo, M.S.N., R.N., C.P.N.P., as soon as you can to take advantage of optimum time slots and avoid delays. 
  • Your nurse practitioner and behavioral psychologist want to spend as much time as possible with you and your child. Therefore, please arrive on time. If you are more than 15 minutes late, the appointment will have to be rescheduled.
  • We request 24 to 48 hours notice if you must cancel an appointment.
  • To maximize your time with us, please turn off cell phones and pagers during your visit. If possible, arrange childcare or babysitting for siblings or other children in your care.

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