Treatment of Functional Constipation in Children

Introduction to Treatment Options

The American Academy of Pediatrics recommends adding polyethylene glycol (MiraLAX) as the most effective next step in correcting functional constipation in children, as it has demonstrated superior efficacy compared to other interventions 1, 2
Increasing fluid intake is recommended as part of comprehensive management, but it alone is insufficient to treat established functional constipation, and should be considered an adjunctive measure alongside PEG rather than primary therapy 1, 2

Exercise is appropriate as a supportive measure but has limited evidence as a primary intervention for established constipation, and physical activity alone would not address the child's fear of painful defecation 1
Stool softeners like docusate have been shown to be less effective than osmotic laxatives like PEG, and studies have demonstrated that adding docusate to stimulant laxatives provides no additional benefit over stimulant laxatives alone 2
Education for parents about normal bowel function and the pathophysiology of constipation is an important part of comprehensive management 1