Treatment of Pediatric Constipation

Initial Assessment and Management

Constipation is a common lifelong problem in children that must be aggressively treated to prevent complications such as rectal prolapse, hemorrhoids, and intestinal perforation 1, 2
The American Academy of Pediatrics recommends increasing water and fiber in the diet followed by osmotic laxative therapy, with polyethylene glycol (PEG) being the preferred agent for children over 6 months of age and lactulose for infants under 6 months 1, 2

Dietary modifications, including increasing water intake and dietary fiber, are recommended for the treatment of pediatric constipation 1, 2
Avoiding foods high in simple sugars and fats is also recommended 3, 4
Establishing proper toilet posture with buttock support, foot support, and comfortable hip abduction is a recommended behavioral intervention 5, 6
Implementing a regular toileting program and educating the child and family about the importance of maintaining treatment long-term are also recommended 1, 2, 5, 6

Premature discontinuation of treatment is a common pitfall that can lead to relapse 2, 5, 6
The American Academy of Pediatrics recommends monitoring response to treatment and adjusting dosing as needed, as well as being prepared to restart medication promptly if symptoms recur 2