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The prevalence of constipation in children is high and accounts for a large percentage of pediatric and pediatric gastroenterology visits. Thyroid testing is frequently ordered to evaluate constipation and other gastrointestinal complaints in children. We reviewed all of the patients with thyroid testing ordered by our pediatric gastroenterology division during a 5-year period. We found 873 patients on whom thyroid testing was performed, and 56 patients had evidence of hypothyroidism. Nine patients had constipation and clinically significant hypothyroidism in this group; however, only 1 child had constipation as their sole presenting symptom. The contribution of occult hypothyroidism to isolated constipation in children may have been previously overestimated.