Bowel - Bladder Dysfunction: Can Constipation be the First Presenting Symptom of Urinary Tract Disorder?

Functional defecation disorders compromise a common clinical entity for pediatricians. The diagnosis and management of these problems are complex and time consuming. Currently, Rome III criteria provide a standard terminology in clinical practice. Functional voiding symptoms are also common in children. It is well known that both constipation and voiding symptoms can be a risk factor for each other. In a certain group of patients, functional defecation and voiding symptoms may be a component of a single disorder as dysfunctional elimination or bowelbladder syndrome. Therefore, constipation should be investigated in children with voiding symptoms, and treatment of constipation must also be included in the management. Similarly, possibility of lower urinary tract symptoms and urinary infections should be considered in children presenting with constipation.