A new study published in Pediatric Gastroenterology, Hepatology & Nutrition compared the characteristics of the children who failed outpatient treatment and needed inpatient treatment to those who achieved success with outpatient treatment only, in an effort to identify attributes which increase the risk for hospitalization. This was a retrospective cohort study, which reviewed medical records of all patients aged 0-21 years with chronic functional constipation and fecal impaction, who visited the pediatric gastroenterology clinic over a period of 2 years. Overall, 188 patients were enrolled. It was observed that 69.2% of the patients were successfully treated (the outpatient group), while 30.9% failed outpatient treatment and were hospitalized (the inpatient group). It was noted that the characteristics of the inpatient group, vis, age at onset, ethnicity, prematurity, developmental delay, overflow incontinence, picky eating habits, number of ROME III criteria met, interquartile range, and constipation related prior encounters, were significantly different from the outpatient group. From the observations, it was stated that identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment in children with fecal impaction.