Table 1 Red Flags: Common symptoms and signs to suggest organic causes of constipation

Failure to thrive

Absent/Brisk lower limb reflexes

Delayed passage of meconium

Mouth ulcers

Abnormal bowel habit since birth

Blood/mucus mixed in with stool

Sensitivity to cold, fatigue, dry skin, pallor

Perianal skin tags or fistulae

Change of bowels with introduction of cow's milk

Associated hypotonia

Weight loss

Fever