Materiały źródłowe

• #1 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. Polyethylene glycol is the first-line treatment for constipation. Second-line options include lactulose and enemas. Increasing dietary fiber and fluid intake above usual daily recommendations and adding probiotics provide no additional benefits for treating constipation. Frequent follow-up visits and referrals to a psychologist can assist in reaching some treatment goals. Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers’ specific challenges and the negative effects of constipation on the child’s quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #2

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  Constipation is a common problem in children. In fact, roughly 1 in every 20 visits children make to a doctor are because of constipation. Children with constipation may have stools (poops or bowel movementsBMs) that are hard, dry and difficult or painful to get out. Some children with constipation have infrequent stools. […] Most children have functional constipation. It can happen when children hold back bowel movements. It also can happen after a child has had a gastrointestinal infection. […] Functional constipation usually results from withholding behaviors: a fear of pain or discomfort from pooping, or a lack of awareness of the body’s signs for needing to poop, have led to significant discomfort for the child. […] It is important to note that some children may develop functional constipation after a gastrointestinal illness (diarrhea stomach „bug” or stomach flu). This is known as post-infectious functional constipation.

• #3 Pediatric Functional Constipation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537037/

  Functional constipation is a common problem in childhood, with an estimated prevalence of 3% worldwide. […] Constipation is defined as functional constipation if there is no underlying organic cause, which is the case in up to 95% of children. […] This condition can be seen in healthy children 1 year and older and is particularly common among preschool-aged children. […] Functional constipation is often described as difficult or infrequent bowel movements/ deviation from normal frequency, painful defecation, the passage of hard stools, and/or the sensation of incomplete evacuation of stool. […] It is usually multifactorial, including environmental conditions, stress, diet, coping skills, and social support. […] The first phase of treatment is to empty the hard stool from the colon, also known as disimpaction.

• #4 Patient education: Constipation in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/constipation-in-infants-and-children-beyond-the-basics

  Constipation is a common problem in children of all ages. A child with constipation may have bowel movements less frequently than normal, or their bowel movements may be hard, large-caliber, or difficult and painful to pass. […] Most children with constipation do not have an identifiable underlying medical problem causing their symptoms. Constipation generally resolves with changes in diet or behavior or sometimes with medicine. You can try some of these treatments at home. If home treatment is not helpful, talk to your child’s health care provider. […] Constipation is particularly common at three times in an infant’s and child’s life: after starting cereal and puréed foods, during toilet training, and after starting school. Parents can help by being aware of these high-risk times, working to prevent constipation, recognizing the problem if it develops, and acting quickly so that constipation does not become a bigger problem.

• #5 Pediatric Functional Constipation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537037/

  Functional constipation is a common problem in childhood, with an estimated prevalence of 3% worldwide. […] Constipation is defined as functional constipation if there is no underlying organic cause, which is the case in up to 95% of children. […] This condition can be seen in healthy children 1 year and older and is particularly common among preschool-aged children. […] Functional constipation is often described as difficult or infrequent bowel movements/ deviation from normal frequency, painful defecation, the passage of hard stools, and/or the sensation of incomplete evacuation of stool. […] It is usually multifactorial, including environmental conditions, stress, diet, coping skills, and social support. […] The first phase of treatment is to empty the hard stool from the colon, also known as disimpaction.

• #6 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children and adolescents is defined as passing delayed or infrequent hard stools with pain and excessive straining. The prevalence of constipation in children and adolescents is estimated to be as high as 30% worldwide. Constipation in children accounts for 3% of primary care physician visits and up to 25% of referrals to pediatric gastroenterologists. Children with constipation incur three times the health care costs of children without constipation, and chronic constipation can have a negative effect on the child’s quality of life. […] Functional constipation is diagnosed by history and physical examination findings in patients without red flag signs or symptoms. Digital rectal examination and abdominal radiography should not be performed routinely in children with suspected functional constipation. Increasing fiber or fluid intake above usual daily recommendations does not improve constipation in children. Probiotics are not beneficial in the treatment of constipation in children. Referring children with functional constipation to a child psychologist can improve some constipation outcomes. Polyethylene glycol (Miralax) is first-line treatment for functional constipation in children.

• #7 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children and adolescents is defined as passing delayed or infrequent hard stools with pain and excessive straining. The prevalence of constipation in children and adolescents is estimated to be as high as 30% worldwide. Constipation in children accounts for 3% of primary care physician visits and up to 25% of referrals to pediatric gastroenterologists. Children with constipation incur three times the health care costs of children without constipation, and chronic constipation can have a negative effect on the child’s quality of life. […] Functional constipation is diagnosed by history and physical examination findings in patients without red flag signs or symptoms. Digital rectal examination and abdominal radiography should not be performed routinely in children with suspected functional constipation. Increasing fiber or fluid intake above usual daily recommendations does not improve constipation in children. Probiotics are not beneficial in the treatment of constipation in children. Referring children with functional constipation to a child psychologist can improve some constipation outcomes. Polyethylene glycol (Miralax) is first-line treatment for functional constipation in children.

• #8 Constipation in children and young people: diagnosis and management – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554924/

  Constipation is common in childhood. It is prevalent in around 530% of the child population, depending on the criteria used for diagnosis. Symptoms become chronic in more than one third of patients and constipation is a common reason for referral to secondary care. […] Painful defecation is an important factor in constipation but it is not always recognised; withholding behaviours to prevent passage of painful stools are often confused with straining to pass stools. Families may delay seeking help for fear of a negative response from healthcare professionals. […] Without early diagnosis and treatment, an acute episode of constipation can lead to anal fissure and become chronic. By the time the child or young person is seen they may be in a vicious cycle. […] Early identification of constipation and effective treatment can improve outcomes for children and young people. This guideline provides strategies based on the best available evidence to support early identification, positive diagnosis and timely, effective management.

• #9 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children and adolescents is defined as passing delayed or infrequent hard stools with pain and excessive straining. The prevalence of constipation in children and adolescents is estimated to be as high as 30% worldwide. Constipation in children accounts for 3% of primary care physician visits and up to 25% of referrals to pediatric gastroenterologists. Children with constipation incur three times the health care costs of children without constipation, and chronic constipation can have a negative effect on the child’s quality of life. […] Functional constipation is diagnosed by history and physical examination findings in patients without red flag signs or symptoms. Digital rectal examination and abdominal radiography should not be performed routinely in children with suspected functional constipation. Increasing fiber or fluid intake above usual daily recommendations does not improve constipation in children. Probiotics are not beneficial in the treatment of constipation in children. Referring children with functional constipation to a child psychologist can improve some constipation outcomes. Polyethylene glycol (Miralax) is first-line treatment for functional constipation in children.

• #10 Constipation in Children: Causes, Signs & Treatment | CHOC

  https://choc.org/programs-services/gastroenterology/constipation/

  Constipation is a condition in which a person has painful or infrequent bowel movements that result in the passage of small amounts of hard, dry stool. Constipation is common in children, accounting for 5% of general pediatric visits and 25% of pediatric gastroenterology visits each year. […] More than 90 percent of constipated children have “functional” constipation, which is constipation without any underlying disease. Once children pass hard, painful bowel movements, they learn to withhold stool to prevent further pain. […] Constipation is typically caused by an external factor or change in diet/lifestyle, but more severe or chronic cases of constipation can be due to an underlying condition. […] Common life events that are linked to episodes of constipation in children include: Changing from breast milk to formula, Introduction of solid foods, Starting cow’s milk, Toilet training, Travel or camping, Viral illness.

• #11 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  Constipation in children is a common problem. A constipated child has infrequent bowel movements or hard, dry stools. […] Encouraging your child to make simple dietary changes such as eating more fiber-rich fruits and vegetables and drinking more water can go a long way toward alleviating constipation. If your child’s doctor approves, it may be possible to treat a child’s constipation with laxatives. […] Constipation in children usually isn’t serious. However, chronic constipation may lead to complications or signal an underlying condition. Take your child to a doctor if the constipation lasts longer than two weeks or is accompanied by: Fever, Not eating, Blood in the stool, Abdominal swelling, Weight loss, Pain during bowel movements, Part of the intestine coming out of the anus (rectal prolapse).

• #12 Constipation and children | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation-and-children

  Some children ignore the urge to go to the toilet because they are too busy playing. […] Some children hold back when they are being toilet trained. […] Some children dont want to use school or preschool toilets for various reasons, such as lack of privacy or a smelly toilet. […] The child may not be getting enough exercise. […] Some of the signs of constipation in children include: saying that it hurts when doing a poo, showing signs of holding on such as crossing legs, running around, crying or refusing to sit on the toilet, complaining of tummy pain, soiling their pants (with ongoing constipation). […] Suggestions for treating constipation in children include: Encourage your child to exercise more. […] Establish a regular toilet routine. […] Limit the use of laxatives. […] Try to solve the problem quickly the longer your child remains constipated, the worse it may become and the longer it may take to treat.

• #13

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  Sometimes, a withholding cycle when the child holds in the poop day after day can cause more severe symptoms like intense abdominal pain (stomach aches) or bloating, decreased appetite, nausea or reflux, diarrhea from bowel overflow. […] When poop overflows like diarrhea because of constipation, we call this encopresis. Encopresis can be very alarming to children and parents because it can look like diarrhea caused by infections. However, it is actually the child’s body attempting to evacuate a large amount of poop. […] The large, rocky hard poops caused by constipation can cause injury to the skin around the rectum and anus when a child finally has a poop. This can lead to pain with pooping, but the hard poops can also tear the skin around the rectum. This can cause bleeding. […] Many treatments and strategies exist to help children manage their constipation. While some of these medicines are over the counter, we recommend that you discuss any treatments with your child’s doctor before starting.

• #14 Constipation and children | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation-and-children

  Constipation is the passing of a hard bowel motion (poo) with pain and discomfort. […] Common causes of constipation include lack of water and not enough fibre in the diet. […] Constipation in babies needs special care. […] A healthy diet, having enough to drink, exercise, correct toilet training and regular toilet habits are important to prevent and help treat constipation in children. Treatment for infant constipation requires expert medical advice. […] Constipation is not just how often a child goes to the toilet. It also refers to how hard the stool (poo) is when it is passed. […] Constipation that goes on for a long time can cause other problems for children, such as soiling softer poo leaks out around a solid lump of poo and dirties underpants. […] The causes of a child’s constipation may not always be clear, but may include: If a child is drinking too much milk and not getting enough solids, the lack of fibre can cause constipation.

• #15

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  Sometimes, a withholding cycle when the child holds in the poop day after day can cause more severe symptoms like intense abdominal pain (stomach aches) or bloating, decreased appetite, nausea or reflux, diarrhea from bowel overflow. […] When poop overflows like diarrhea because of constipation, we call this encopresis. Encopresis can be very alarming to children and parents because it can look like diarrhea caused by infections. However, it is actually the child’s body attempting to evacuate a large amount of poop. […] The large, rocky hard poops caused by constipation can cause injury to the skin around the rectum and anus when a child finally has a poop. This can lead to pain with pooping, but the hard poops can also tear the skin around the rectum. This can cause bleeding. […] Many treatments and strategies exist to help children manage their constipation. While some of these medicines are over the counter, we recommend that you discuss any treatments with your child’s doctor before starting.

• #16

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  Sometimes, a withholding cycle when the child holds in the poop day after day can cause more severe symptoms like intense abdominal pain (stomach aches) or bloating, decreased appetite, nausea or reflux, diarrhea from bowel overflow. […] When poop overflows like diarrhea because of constipation, we call this encopresis. Encopresis can be very alarming to children and parents because it can look like diarrhea caused by infections. However, it is actually the child’s body attempting to evacuate a large amount of poop. […] The large, rocky hard poops caused by constipation can cause injury to the skin around the rectum and anus when a child finally has a poop. This can lead to pain with pooping, but the hard poops can also tear the skin around the rectum. This can cause bleeding. […] Many treatments and strategies exist to help children manage their constipation. While some of these medicines are over the counter, we recommend that you discuss any treatments with your child’s doctor before starting.

• #17 Constipation in Children – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/symptoms-in-infants-and-children/constipation-in-children

  The urge to defecate is then decreased, and the stool becomes harder, leading to a vicious circle of painful defecation and worsened constipation. […] Occasionally, soft stool passes around the impacted stool and leads to stool incontinence (encopresis). […] In older children, diets low in fiber and high in dairy may lead to hard stools that are uncomfortable to pass and can cause anal fissures. […] Stress, desire for control, and sexual abuse are also some of the functional causes of stool retention and subsequent constipation. […] Evaluation should focus on differentiating functional constipation from constipation with an organic cause. […] A primary finding that suggests an organic cause in neonates is constipation from birth; those who have had a normal bowel movement are unlikely to have a significant structural disorder.

• #18 Pediatric Functional Constipation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537037/

  Functional constipation is a common problem in childhood, with an estimated prevalence of 3% worldwide. […] Constipation is defined as functional constipation if there is no underlying organic cause, which is the case in up to 95% of children. […] This condition can be seen in healthy children 1 year and older and is particularly common among preschool-aged children. […] Functional constipation is often described as difficult or infrequent bowel movements/ deviation from normal frequency, painful defecation, the passage of hard stools, and/or the sensation of incomplete evacuation of stool. […] It is usually multifactorial, including environmental conditions, stress, diet, coping skills, and social support. […] The first phase of treatment is to empty the hard stool from the colon, also known as disimpaction.

• #19

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut1883

  For children 1 year or older, give your child plenty of water and other fluids. Include high-fibre foods like fruits, vegetables, beans, or whole grains in your child’s diet each day. Have your child take medicines exactly as prescribed. Call your doctor or nurse advice line if you think your child is having a problem with a medicine. Make sure your child gets daily exercise. It helps the body have regular bowel movements. Tell your child to go to the toilet when they have the urge. Do not give laxatives or enemas to your child unless your child’s doctor recommends it. Make a routine of putting your child on the toilet or potty chair after the same meal each day. […] If your child’s constipation doesn’t get better with home treatment, talk to your child’s doctor. Your child’s doctor may recommend the following to treat and manage constipation: Education: Learning about constipation including why your child is constipated and how to help your child to have soft stools they can pass easily without pain is the first step to managing it.

• #20

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut1883

  Constipation is difficulty passing hard stools and passing fewer stools. How often your child has a bowel movement is not as important as whether the child can pass stools easily. Constipation has many causes in children. These include medicines, changes in diet, not drinking enough fluids, and changes in routine. […] You can prevent constipation or treat it when it happens with home care. But some children may have ongoing constipation. It can occur when a child does not eat enough fibre. Or toilet training may make a child want to hold in stools. Children at play may not want to take time to go to the toilet. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems. It’s also a good idea to know your child’s test results and keep a list of the medicines your child takes.

• #21 Constipation in children | healthdirect

  https://www.healthdirect.gov.au/constipation-in-children

  Some children who are constipated may have an anal fissure. This is a small split in the anus (bottom) that causes pain and bleeding. This occurs because they have been straining (pushing hard) to pass poo. […] In babies, constipation can cause dry and crumbly poos. It can also cause pain while pooing. […] Constipation in babies can happen if they aren’t having enough breastmilk or if their formula isn’t made up properly. It can also develop when solid foods are started. […] Children can become constipated if they: don’t eat enough fibre, drink too much milk and don’t eat enough solid foods, have an illness that makes them eat and drink less, take certain medicines, such as some cough medicines. […] They may also hold back bowel movements (poo), instead of going when they need to go. This can happen if it’s been painful for them to poo before.

• #22 Constipation in Children: Causes, Signs & Treatment | CHOC

  https://choc.org/programs-services/gastroenterology/constipation/

  Constipation is a condition in which a person has painful or infrequent bowel movements that result in the passage of small amounts of hard, dry stool. Constipation is common in children, accounting for 5% of general pediatric visits and 25% of pediatric gastroenterology visits each year. […] More than 90 percent of constipated children have “functional” constipation, which is constipation without any underlying disease. Once children pass hard, painful bowel movements, they learn to withhold stool to prevent further pain. […] Constipation is typically caused by an external factor or change in diet/lifestyle, but more severe or chronic cases of constipation can be due to an underlying condition. […] Common life events that are linked to episodes of constipation in children include: Changing from breast milk to formula, Introduction of solid foods, Starting cow’s milk, Toilet training, Travel or camping, Viral illness.

• #23

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  Constipation is a common problem in children. In fact, roughly 1 in every 20 visits children make to a doctor are because of constipation. Children with constipation may have stools (poops or bowel movementsBMs) that are hard, dry and difficult or painful to get out. Some children with constipation have infrequent stools. […] Most children have functional constipation. It can happen when children hold back bowel movements. It also can happen after a child has had a gastrointestinal infection. […] Functional constipation usually results from withholding behaviors: a fear of pain or discomfort from pooping, or a lack of awareness of the body’s signs for needing to poop, have led to significant discomfort for the child. […] It is important to note that some children may develop functional constipation after a gastrointestinal illness (diarrhea stomach „bug” or stomach flu). This is known as post-infectious functional constipation.

• #24 Constipation in Children – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/symptoms-in-infants-and-children/constipation-in-children

  The urge to defecate is then decreased, and the stool becomes harder, leading to a vicious circle of painful defecation and worsened constipation. […] Occasionally, soft stool passes around the impacted stool and leads to stool incontinence (encopresis). […] In older children, diets low in fiber and high in dairy may lead to hard stools that are uncomfortable to pass and can cause anal fissures. […] Stress, desire for control, and sexual abuse are also some of the functional causes of stool retention and subsequent constipation. […] Evaluation should focus on differentiating functional constipation from constipation with an organic cause. […] A primary finding that suggests an organic cause in neonates is constipation from birth; those who have had a normal bowel movement are unlikely to have a significant structural disorder.

• #25 Constipation and children | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation-and-children

  Some children ignore the urge to go to the toilet because they are too busy playing. […] Some children hold back when they are being toilet trained. […] Some children dont want to use school or preschool toilets for various reasons, such as lack of privacy or a smelly toilet. […] The child may not be getting enough exercise. […] Some of the signs of constipation in children include: saying that it hurts when doing a poo, showing signs of holding on such as crossing legs, running around, crying or refusing to sit on the toilet, complaining of tummy pain, soiling their pants (with ongoing constipation). […] Suggestions for treating constipation in children include: Encourage your child to exercise more. […] Establish a regular toilet routine. […] Limit the use of laxatives. […] Try to solve the problem quickly the longer your child remains constipated, the worse it may become and the longer it may take to treat.

• #26 Constipation in Children: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.constipation-in-children-care-instructions.ut1883

  Constipation is difficulty passing hard stools and passing fewer stools. How often your child has a bowel movement is not as important as whether the child can pass stools easily. Constipation has many causes in children. These include medicines, changes in diet, not drinking enough fluids, and changes in routine. […] You can prevent constipation or treat it when it happens with home care. But some children may have ongoing constipation. It can occur when a child does not eat enough fiber. Or toilet training may make a child want to hold in stools. Children at play may not want to take time to go to the bathroom. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It’s also a good idea to know your child’s test results and keep a list of the medicines your child takes.

• #27 Constipation and children | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation-and-children

  Some children ignore the urge to go to the toilet because they are too busy playing. […] Some children hold back when they are being toilet trained. […] Some children dont want to use school or preschool toilets for various reasons, such as lack of privacy or a smelly toilet. […] The child may not be getting enough exercise. […] Some of the signs of constipation in children include: saying that it hurts when doing a poo, showing signs of holding on such as crossing legs, running around, crying or refusing to sit on the toilet, complaining of tummy pain, soiling their pants (with ongoing constipation). […] Suggestions for treating constipation in children include: Encourage your child to exercise more. […] Establish a regular toilet routine. […] Limit the use of laxatives. […] Try to solve the problem quickly the longer your child remains constipated, the worse it may become and the longer it may take to treat.

• #28 Constipation in children | healthdirect

  https://www.healthdirect.gov.au/constipation-in-children

  Some children who are constipated may have an anal fissure. This is a small split in the anus (bottom) that causes pain and bleeding. This occurs because they have been straining (pushing hard) to pass poo. […] In babies, constipation can cause dry and crumbly poos. It can also cause pain while pooing. […] Constipation in babies can happen if they aren’t having enough breastmilk or if their formula isn’t made up properly. It can also develop when solid foods are started. […] Children can become constipated if they: don’t eat enough fibre, drink too much milk and don’t eat enough solid foods, have an illness that makes them eat and drink less, take certain medicines, such as some cough medicines. […] They may also hold back bowel movements (poo), instead of going when they need to go. This can happen if it’s been painful for them to poo before.

• #29

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  Constipation is a common problem in children. In fact, roughly 1 in every 20 visits children make to a doctor are because of constipation. Children with constipation may have stools (poops or bowel movementsBMs) that are hard, dry and difficult or painful to get out. Some children with constipation have infrequent stools. […] Most children have functional constipation. It can happen when children hold back bowel movements. It also can happen after a child has had a gastrointestinal infection. […] Functional constipation usually results from withholding behaviors: a fear of pain or discomfort from pooping, or a lack of awareness of the body’s signs for needing to poop, have led to significant discomfort for the child. […] It is important to note that some children may develop functional constipation after a gastrointestinal illness (diarrhea stomach „bug” or stomach flu). This is known as post-infectious functional constipation.

• #30 Constipation in Children: Causes, Signs & Treatment | CHOC

  https://choc.org/programs-services/gastroenterology/constipation/

  Constipation is a condition in which a person has painful or infrequent bowel movements that result in the passage of small amounts of hard, dry stool. Constipation is common in children, accounting for 5% of general pediatric visits and 25% of pediatric gastroenterology visits each year. […] More than 90 percent of constipated children have “functional” constipation, which is constipation without any underlying disease. Once children pass hard, painful bowel movements, they learn to withhold stool to prevent further pain. […] Constipation is typically caused by an external factor or change in diet/lifestyle, but more severe or chronic cases of constipation can be due to an underlying condition. […] Common life events that are linked to episodes of constipation in children include: Changing from breast milk to formula, Introduction of solid foods, Starting cow’s milk, Toilet training, Travel or camping, Viral illness.

• #31 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. Polyethylene glycol is the first-line treatment for constipation. Second-line options include lactulose and enemas. Increasing dietary fiber and fluid intake above usual daily recommendations and adding probiotics provide no additional benefits for treating constipation. Frequent follow-up visits and referrals to a psychologist can assist in reaching some treatment goals. Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers’ specific challenges and the negative effects of constipation on the child’s quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #32 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. Polyethylene glycol is the first-line treatment for constipation. Second-line options include lactulose and enemas. Increasing dietary fiber and fluid intake above usual daily recommendations and adding probiotics provide no additional benefits for treating constipation. Frequent follow-up visits and referrals to a psychologist can assist in reaching some treatment goals. Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers’ specific challenges and the negative effects of constipation on the child’s quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #33 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children and adolescents is defined as passing delayed or infrequent hard stools with pain and excessive straining. The prevalence of constipation in children and adolescents is estimated to be as high as 30% worldwide. Constipation in children accounts for 3% of primary care physician visits and up to 25% of referrals to pediatric gastroenterologists. Children with constipation incur three times the health care costs of children without constipation, and chronic constipation can have a negative effect on the child’s quality of life. […] Functional constipation is diagnosed by history and physical examination findings in patients without red flag signs or symptoms. Digital rectal examination and abdominal radiography should not be performed routinely in children with suspected functional constipation. Increasing fiber or fluid intake above usual daily recommendations does not improve constipation in children. Probiotics are not beneficial in the treatment of constipation in children. Referring children with functional constipation to a child psychologist can improve some constipation outcomes. Polyethylene glycol (Miralax) is first-line treatment for functional constipation in children.

• #34 Managing Functional Constipation | Children’s Mercy Kansas City

  https://www.childrensmercy.org/health-care-providers/pediatrician-guides/managing-functional-constipation/

  In the absence of clinical features indicative of a specific disorder, or red flag symptoms, testing is not recommended or required to make the diagnosis of functional constipation. […] Frequently used maintenance medical management includes dietary modification or use of osmotic laxatives. Although sometimes effective, dietary modification for pediatric functional constipation has poor evidence to support its use. […] Identification of constipation as the diagnosis. […] Education of the patient and family about the diagnosis. […] Cleanout/disimpaction if large stool burden is present. […] Maintenance medical and behavioral management plan to prevent exacerbation. […] Children who do not respond to the disimpaction or maintenance therapies may require a referral to a pediatric gastroenterologist for further evaluation.

• #35 Constipation in children – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/diagnosis-treatment/drc-20354248

  Your child’s doctor will: […] Conduct a physical exam. Your child’s physical exam will likely include placing a gloved finger into your child’s anus to check for abnormalities or the presence of impacted stool. Stool found in the rectum may be tested for blood. […] Depending on the circumstances, your child’s doctor may recommend: […] Over-the-counter fiber supplements or stool softeners. If your child doesn’t get a lot of fiber in his or her diet, adding an over-the-counter fiber supplement, such as Metamucil or Citrucel, might help. […] Glycerin suppositories can be used to soften the stool in children who can’t swallow pills. Talk with your child’s doctor about the right way to use these products. […] A laxative or enema. If an accumulation of fecal material creates a blockage, your child’s doctor may suggest a laxative or enema to help remove the blockage.

• #36 Managing Functional Constipation | Children’s Mercy Kansas City

  https://www.childrensmercy.org/health-care-providers/pediatrician-guides/managing-functional-constipation/

  Constipation is an extremely common presenting symptom in children. To assist with patient diagnosis and treatment, the Childrens Mercy Gastroenterology team created the following recommendations. […] Functional constipation is defined by Rome IV criteria (consensus, expert, clinical definition based on symptoms only) and having at least 2 of the following for at least one month: […] Symptoms cannot be explained by another condition. […] Though constipation is prevalent in children and infrequently a result of underlying intestinal or systemic disease, red flag symptoms and diagnostic clues should be used to identify an underlying disease responsible for constipation. If the patient displays one or more of the red flag symptoms below, referral to pediatric gastroenterology is indicated.

• #37 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children and adolescents is defined as passing delayed or infrequent hard stools with pain and excessive straining. The prevalence of constipation in children and adolescents is estimated to be as high as 30% worldwide. Constipation in children accounts for 3% of primary care physician visits and up to 25% of referrals to pediatric gastroenterologists. Children with constipation incur three times the health care costs of children without constipation, and chronic constipation can have a negative effect on the child’s quality of life. […] Functional constipation is diagnosed by history and physical examination findings in patients without red flag signs or symptoms. Digital rectal examination and abdominal radiography should not be performed routinely in children with suspected functional constipation. Increasing fiber or fluid intake above usual daily recommendations does not improve constipation in children. Probiotics are not beneficial in the treatment of constipation in children. Referring children with functional constipation to a child psychologist can improve some constipation outcomes. Polyethylene glycol (Miralax) is first-line treatment for functional constipation in children.

• #38 Pediatric Constipation | Doernbecher Children’s Hospital | OHSU

  https://www.ohsu.edu/doernbecher/pediatric-constipation

  Your childs doctor can do an exam and ask about your childs symptoms. If your childs constipation doesnt go away or keeps coming back, tests might include: […] The most common ways to treat constipation in children include: […] Have your child eat high-fiber foods. […] Set up a bathroom routine. This can be once or twice a day for 10 minutes, usually after a meal. […] Make sure your child is physically active. […] Track your childs bowel movements in a diary. […] If your child gets constipated during toilet training, stop for a while. Waiting a few months may be better than forcing the issue.

• #39 Evaluation and Treatment of Constipation in Children and Adolescents | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0715/p82.html

  The addition of laxatives is more effective than behavior modification alone in children with constipation. […] Most children with functional constipation require prolonged treatment. […] The treatment of functional constipation requires parental education, behavior interventions, measures to ensure that bowel movements occur at normal intervals with good evacuation, close follow-up, and adjustment of medication and evaluation as necessary. […] Education is the first step in treatment. […] Dietary changes are often advised in children with constipation. […] When fecal impaction is present, disimpaction with oral or rectal medication is required before initiation of maintenance therapy. […] The goal of maintenance therapy is to avoid reaccumulation of stool by maintaining soft bowel movements, preferably occurring once a day. […] Most children with functional constipation require prolonged treatment and have frequent relapses. […] Referral to a pediatric gastroenterologist may be needed when a child with constipation has red flags for organic disease or the constipation is unresponsive to adequate therapy.

• #40 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. Polyethylene glycol is the first-line treatment for constipation. Second-line options include lactulose and enemas. Increasing dietary fiber and fluid intake above usual daily recommendations and adding probiotics provide no additional benefits for treating constipation. Frequent follow-up visits and referrals to a psychologist can assist in reaching some treatment goals. Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers’ specific challenges and the negative effects of constipation on the child’s quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #41 Evaluation and Treatment of Constipation in Children and Adolescents | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0715/p82.html

  The addition of laxatives is more effective than behavior modification alone in children with constipation. […] Most children with functional constipation require prolonged treatment. […] The treatment of functional constipation requires parental education, behavior interventions, measures to ensure that bowel movements occur at normal intervals with good evacuation, close follow-up, and adjustment of medication and evaluation as necessary. […] Education is the first step in treatment. […] Dietary changes are often advised in children with constipation. […] When fecal impaction is present, disimpaction with oral or rectal medication is required before initiation of maintenance therapy. […] The goal of maintenance therapy is to avoid reaccumulation of stool by maintaining soft bowel movements, preferably occurring once a day. […] Most children with functional constipation require prolonged treatment and have frequent relapses. […] Referral to a pediatric gastroenterologist may be needed when a child with constipation has red flags for organic disease or the constipation is unresponsive to adequate therapy.

• #42 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation. Fecal impaction can be diagnosed by a history of overflow soiling, the presence of a palpable fecal mass during an abdominal examination, or hard stool in a dilated rectum if a digital rectal examination is warranted. Disimpaction can be achieved by using oral or rectal medications. Polyethylene glycol (Miralax) is a polymer that is minimally absorbed by the gastrointestinal tract, leading to water retention in the intestine and softened stools. Polyethylene glycol is the first-line treatment because it is more effective than other agents for disimpaction and maintenance therapy, is well-tolerated, and has a low risk of adverse effects. […] Maintenance therapy should be started in children without impaction or when disimpaction is achieved. The goals of maintenance therapy are to achieve soft stool daily or every other day and to prevent stool impaction. Polyethylene glycol is superior to other oral laxatives and is recommended as a first-line maintenance treatment for constipation. The starting maintenance dosage of polyethylene glycol is 0.4 g per kg per day, and caregivers should be advised that it can be increased or decreased to maintain soft stool every day or every other day without diarrhea. Polyethylene glycol appears to be safe for long-term use in children.

• #43 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation. Fecal impaction can be diagnosed by a history of overflow soiling, the presence of a palpable fecal mass during an abdominal examination, or hard stool in a dilated rectum if a digital rectal examination is warranted. Disimpaction can be achieved by using oral or rectal medications. Polyethylene glycol (Miralax) is a polymer that is minimally absorbed by the gastrointestinal tract, leading to water retention in the intestine and softened stools. Polyethylene glycol is the first-line treatment because it is more effective than other agents for disimpaction and maintenance therapy, is well-tolerated, and has a low risk of adverse effects. […] Maintenance therapy should be started in children without impaction or when disimpaction is achieved. The goals of maintenance therapy are to achieve soft stool daily or every other day and to prevent stool impaction. Polyethylene glycol is superior to other oral laxatives and is recommended as a first-line maintenance treatment for constipation. The starting maintenance dosage of polyethylene glycol is 0.4 g per kg per day, and caregivers should be advised that it can be increased or decreased to maintain soft stool every day or every other day without diarrhea. Polyethylene glycol appears to be safe for long-term use in children.

• #44 Constipation in children – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/diagnosis-treatment/drc-20354248

  Your child’s doctor will: […] Conduct a physical exam. Your child’s physical exam will likely include placing a gloved finger into your child’s anus to check for abnormalities or the presence of impacted stool. Stool found in the rectum may be tested for blood. […] Depending on the circumstances, your child’s doctor may recommend: […] Over-the-counter fiber supplements or stool softeners. If your child doesn’t get a lot of fiber in his or her diet, adding an over-the-counter fiber supplement, such as Metamucil or Citrucel, might help. […] Glycerin suppositories can be used to soften the stool in children who can’t swallow pills. Talk with your child’s doctor about the right way to use these products. […] A laxative or enema. If an accumulation of fecal material creates a blockage, your child’s doctor may suggest a laxative or enema to help remove the blockage.

• #45 Constipation in children – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/diagnosis-treatment/drc-20354248

  Hospital enema. Sometimes a child may be so severely constipated that he or she needs to be hospitalized for a short time to be given a stronger enema that will clear the bowel (disimpaction). […] In addition to changes in diet and routine, various alternative approaches may help relieve constipation in children: […] Massage. Gently massaging your child’s abdomen may relax the muscles that support the bladder and intestines, helping to promote bowel activity. […] If your child’s constipation lasts longer than two weeks, you’ll likely first seek medical care from your child’s doctor. […] There are several things you can do that might help relieve your child’s constipation before your doctor’s appointment, for example: […] Give your child prune juice. Prune juice can be mixed with other juices (such as apple juice) if your child doesn’t like the taste.

• #46 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation. Fecal impaction can be diagnosed by a history of overflow soiling, the presence of a palpable fecal mass during an abdominal examination, or hard stool in a dilated rectum if a digital rectal examination is warranted. Disimpaction can be achieved by using oral or rectal medications. Polyethylene glycol (Miralax) is a polymer that is minimally absorbed by the gastrointestinal tract, leading to water retention in the intestine and softened stools. Polyethylene glycol is the first-line treatment because it is more effective than other agents for disimpaction and maintenance therapy, is well-tolerated, and has a low risk of adverse effects. […] Maintenance therapy should be started in children without impaction or when disimpaction is achieved. The goals of maintenance therapy are to achieve soft stool daily or every other day and to prevent stool impaction. Polyethylene glycol is superior to other oral laxatives and is recommended as a first-line maintenance treatment for constipation. The starting maintenance dosage of polyethylene glycol is 0.4 g per kg per day, and caregivers should be advised that it can be increased or decreased to maintain soft stool every day or every other day without diarrhea. Polyethylene glycol appears to be safe for long-term use in children.

• #47 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation. Fecal impaction can be diagnosed by a history of overflow soiling, the presence of a palpable fecal mass during an abdominal examination, or hard stool in a dilated rectum if a digital rectal examination is warranted. Disimpaction can be achieved by using oral or rectal medications. Polyethylene glycol (Miralax) is a polymer that is minimally absorbed by the gastrointestinal tract, leading to water retention in the intestine and softened stools. Polyethylene glycol is the first-line treatment because it is more effective than other agents for disimpaction and maintenance therapy, is well-tolerated, and has a low risk of adverse effects. […] Maintenance therapy should be started in children without impaction or when disimpaction is achieved. The goals of maintenance therapy are to achieve soft stool daily or every other day and to prevent stool impaction. Polyethylene glycol is superior to other oral laxatives and is recommended as a first-line maintenance treatment for constipation. The starting maintenance dosage of polyethylene glycol is 0.4 g per kg per day, and caregivers should be advised that it can be increased or decreased to maintain soft stool every day or every other day without diarrhea. Polyethylene glycol appears to be safe for long-term use in children.

• #48 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation. Fecal impaction can be diagnosed by a history of overflow soiling, the presence of a palpable fecal mass during an abdominal examination, or hard stool in a dilated rectum if a digital rectal examination is warranted. Disimpaction can be achieved by using oral or rectal medications. Polyethylene glycol (Miralax) is a polymer that is minimally absorbed by the gastrointestinal tract, leading to water retention in the intestine and softened stools. Polyethylene glycol is the first-line treatment because it is more effective than other agents for disimpaction and maintenance therapy, is well-tolerated, and has a low risk of adverse effects. […] Maintenance therapy should be started in children without impaction or when disimpaction is achieved. The goals of maintenance therapy are to achieve soft stool daily or every other day and to prevent stool impaction. Polyethylene glycol is superior to other oral laxatives and is recommended as a first-line maintenance treatment for constipation. The starting maintenance dosage of polyethylene glycol is 0.4 g per kg per day, and caregivers should be advised that it can be increased or decreased to maintain soft stool every day or every other day without diarrhea. Polyethylene glycol appears to be safe for long-term use in children.

• #49 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. Polyethylene glycol is the first-line treatment for constipation. Second-line options include lactulose and enemas. Increasing dietary fiber and fluid intake above usual daily recommendations and adding probiotics provide no additional benefits for treating constipation. Frequent follow-up visits and referrals to a psychologist can assist in reaching some treatment goals. Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers’ specific challenges and the negative effects of constipation on the child’s quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #50

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  It is important to note that fiber supplements taken without enough water can worsen your child’s constipation! […] Children sometimes have bad posture on the toilet: they slump at the waist and do not sit up straight, they cross their legs, their legs dangle in the air or they clinch their bottom cheeks together. […] One tool to improve toilet posture is the defecation posture modification device, a potty stool. This kind of stool can improve toileting posture by promoting the relaxation of the puborectalis muscle and straightening of the „ano-rectal” angle to make passing a poop easier. […] There are many laxative medicines available to treat children with functional constipation including stool softeners, osmotic laxatives, stimulant laxatives, secretagogue laxatives and rectal therapies.

• #51

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  Constipation should be treated with maintenance medications for at least 2 months. After the 2-month period is completed, the child should be treated for at least 1 additional month while they are asymptomatic. […] Children can become constipated during toilet training. If this happens, your child should CONTINUE toilet training and take their medicines until toilet training is completed and they have been free of symptoms for one additional month. […] In rare cases, children with functional constipation can undergo more testing to determine if the brain and nerves of the gut are working appropriately. […] If you have any questions or concerns about your child’s health, talk with your child’s doctor.

• #52 Childhood constipation

  https://www.racgp.org.au/afp/2017/december/childhood-constipation

  Treatment needs to first disimpact hard stool from the bowel, then maintain ongoing soft stools. […] Successful management of childhood functional constipation in primary care will have a significant positive impact for children and families, and be very rewarding for clinicians. […] Education of appropriate toileting behaviour is essential for longterm success in the management of constipation. […] This should be seen as the main treatment, with the role of laxatives being to facilitate easy passage of stools. […] Disimpaction is often the first step needed to achieve treatment success, to remove the build-up of stool. […] After disimpaction has been achieved (if required), maintenance therapy should be initiated. […] Families should be advised to continue regular laxatives for at least two months, as premature treatment cessation often leads to recurrence within a few weeks.

• #53

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  There is no specific „constipation diet” that has been shown to be effective in preventing or treating constipation. However, increasing water intake and the use of natural fibers from fruits and vegetables are a healthy option that can be recommended to children. […] Making sure that children drink enough water every day is crucial to many bodily functions. […] There are many sources of fiber including from foods and supplements. Food-based, natural fibers are recommended over supplements. […] A simple way to make sure your child is getting enough fiber is by making healthful food choices. If your child is eating at least 5 servings of fruits and vegetables each day along with other foods that are good sources of fiber, there is really no need to count fiber grams. […] If you find it helpful to keep track of total grams of fiber that your child is eating, add 5 to your child’s age.

• #54

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  There is no specific „constipation diet” that has been shown to be effective in preventing or treating constipation. However, increasing water intake and the use of natural fibers from fruits and vegetables are a healthy option that can be recommended to children. […] Making sure that children drink enough water every day is crucial to many bodily functions. […] There are many sources of fiber including from foods and supplements. Food-based, natural fibers are recommended over supplements. […] A simple way to make sure your child is getting enough fiber is by making healthful food choices. If your child is eating at least 5 servings of fruits and vegetables each day along with other foods that are good sources of fiber, there is really no need to count fiber grams. […] If you find it helpful to keep track of total grams of fiber that your child is eating, add 5 to your child’s age.

• #55 Constipation

  https://www.rch.org.au/kidsinfo/fact_sheets/Constipation/

  You only need to worry about the firmness or frequency of your child’s poo if it seems to be causing a problem. In most cases, you can treat your child at home to help their constipation. […] Diet is less important in the treatment of constipation for children than it is for adults, but increasing fibre intake might help some children who have a natural tendency to be constipated. […] If your child is over the age of 18 months, reduce cow’s milk intake to a maximum of 500 ml per day and avoid sweet drinks before meals. This will help to improve your child’s appetite at meal times. […] For older children, if simple diet changes aren’t helping, your child is in significant pain or if they are bleeding from their bottom, you should take them to the GP. […] Constipation can usually be controlled with healthy bowel habits and medicines, as advised by a doctor.

• #56 Constipation

  https://www.rch.org.au/kidsinfo/fact_sheets/Constipation/

  You only need to worry about the firmness or frequency of your child’s poo if it seems to be causing a problem. In most cases, you can treat your child at home to help their constipation. […] Diet is less important in the treatment of constipation for children than it is for adults, but increasing fibre intake might help some children who have a natural tendency to be constipated. […] If your child is over the age of 18 months, reduce cow’s milk intake to a maximum of 500 ml per day and avoid sweet drinks before meals. This will help to improve your child’s appetite at meal times. […] For older children, if simple diet changes aren’t helping, your child is in significant pain or if they are bleeding from their bottom, you should take them to the GP. […] Constipation can usually be controlled with healthy bowel habits and medicines, as advised by a doctor.

• #57

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  There is no specific „constipation diet” that has been shown to be effective in preventing or treating constipation. However, increasing water intake and the use of natural fibers from fruits and vegetables are a healthy option that can be recommended to children. […] Making sure that children drink enough water every day is crucial to many bodily functions. […] There are many sources of fiber including from foods and supplements. Food-based, natural fibers are recommended over supplements. […] A simple way to make sure your child is getting enough fiber is by making healthful food choices. If your child is eating at least 5 servings of fruits and vegetables each day along with other foods that are good sources of fiber, there is really no need to count fiber grams. […] If you find it helpful to keep track of total grams of fiber that your child is eating, add 5 to your child’s age.

• #58

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  It is important to note that fiber supplements taken without enough water can worsen your child’s constipation! […] Children sometimes have bad posture on the toilet: they slump at the waist and do not sit up straight, they cross their legs, their legs dangle in the air or they clinch their bottom cheeks together. […] One tool to improve toilet posture is the defecation posture modification device, a potty stool. This kind of stool can improve toileting posture by promoting the relaxation of the puborectalis muscle and straightening of the „ano-rectal” angle to make passing a poop easier. […] There are many laxative medicines available to treat children with functional constipation including stool softeners, osmotic laxatives, stimulant laxatives, secretagogue laxatives and rectal therapies.

• #59 Pediatric Chronic Constipation – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/chronic-constipation

  If it is determined that there are no underlying serious medical or anatomical problems associated with the cause of constipation, your child will likely begin pediatric chronic constipation treatment in our Bowel Management Program. […] Our Bowel Management Program is a comprehensive program that addresses all of the behavioral and/or medical issues that are contributing to the problem. […] Treatment for chronic constipation through the Bowel Management Program includes: Establishing a bathroom schedule (based around the gastrocolic reflex) to train your child to recognize their body cues, Setting up a reward system to encourage your child to go, Working with nutritionists who help create recipes and diet plans rich in fiber. […] A nurse practitioner and child psychologist work closely with families to monitor your child’s progress and adjust to the treatment plan when needed.

• #60

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  It is important to note that fiber supplements taken without enough water can worsen your child’s constipation! […] Children sometimes have bad posture on the toilet: they slump at the waist and do not sit up straight, they cross their legs, their legs dangle in the air or they clinch their bottom cheeks together. […] One tool to improve toilet posture is the defecation posture modification device, a potty stool. This kind of stool can improve toileting posture by promoting the relaxation of the puborectalis muscle and straightening of the „ano-rectal” angle to make passing a poop easier. […] There are many laxative medicines available to treat children with functional constipation including stool softeners, osmotic laxatives, stimulant laxatives, secretagogue laxatives and rectal therapies.

• #61 Pediatric Functional Constipation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537037/

  In pediatric practice, however, in an outpatient setting, polyethylene glycol (PEG 3350) has become the first-line treatment for FC due to its efficacy and safety profile and because it is well tolerated. […] In the second phase of treatment, the goal is to keep the stool very soft, preventing reaccumulation of hard stool while the colon returns to normal size and function. […] Normal fiber and fluid intake are recommended for children with constipation, along with an average amount of physical activity. […] Children who are toilet trained should be encouraged to sit on the toilet and try to have a bowel movement for 5 to 10 minutes at the same time of day, every day, after the same meal. […] Deterrence and patient education play pivotal roles in addressing pediatric functional constipation.

• #62

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut1883

  For children 1 year or older, give your child plenty of water and other fluids. Include high-fibre foods like fruits, vegetables, beans, or whole grains in your child’s diet each day. Have your child take medicines exactly as prescribed. Call your doctor or nurse advice line if you think your child is having a problem with a medicine. Make sure your child gets daily exercise. It helps the body have regular bowel movements. Tell your child to go to the toilet when they have the urge. Do not give laxatives or enemas to your child unless your child’s doctor recommends it. Make a routine of putting your child on the toilet or potty chair after the same meal each day. […] If your child’s constipation doesn’t get better with home treatment, talk to your child’s doctor. Your child’s doctor may recommend the following to treat and manage constipation: Education: Learning about constipation including why your child is constipated and how to help your child to have soft stools they can pass easily without pain is the first step to managing it.

• #63 Constipation in Children – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/symptoms-in-infants-and-children/constipation-in-children

  For children who are in the process of toilet training, it is sometimes worthwhile to give them a break from training until the constipation resolves. […] Unresponsive constipation is treated by disimpacting the bowel and maintaining a regular diet and stool routine. […] For maintenance of healthy bowels, some children may require over-the-counter dietary fiber supplements. […] Early intervention with dietary and behavior changes can successfully treat functional constipation.

• #64 Constipation in children – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/diagnosis-treatment/drc-20354248

  Cut back on constipating foods. Give toddlers and older children fewer foods that might lead to constipation, such as milk and cheese. […] If possible, take your child for a walk or run. Regular physical activity can encourage bowel movements. […] Ease up on toilet training. If you suspect that toilet training may be playing a role in your child’s constipation, take a break from toilet training for a bit to see if the constipation improves.

• #65 Constipation Nursing Diagnosis & Care Plans | NurseTogether

  https://www.nursetogether.com/constipation-nursing-diagnosis-care-plan/

  Constipation is the decrease in normal frequency of bowel movements. It is also typically accompanied by difficult or incomplete passage of stool and stool that is often extremely hard and dry. Constipation is very common and one of the most frequently seen gastrointestinal complaints. It can affect anyone however the following individuals are more prone to constipation: […] Nursing diagnoses are revised, added, or retired by the NANDA International Diagnosis Development Committee (DDC) to coincide with shifts in language standardization. Constipation has been renamed to Chronic Functional Constipation. Students and seasoned nurses alike may be unfamiliar with this change, and thus NurseTogether has chosen to continue to use the diagnostic label Constipation in this article until the recent relabeling receives wider adoption.

• #66 Constipation Nursing Diagnosis & Care Plan – Nurseslabs

  https://nurseslabs.com/constipation/

  Developing a nursing care plan for constipation requires a thorough understanding of the condition. Learn about constipation and how nurses can improve patient outcomes. Discover assessment, nursing diagnosis, care planning, goal setting, and intervention strategies for constipation nursing care plans. […] Constipation is a common gastrointestinal symptom affecting many individuals and contributes to frequent hospitalizations every year. […] Identifying the underlying cause of constipation is essential to develop an effective nursing care plan that can improve bowel function and relieve symptoms. […] Constipation is a common condition that can be characterized by several signs and symptoms. Identifying these signs and symptoms is critical to develop an accurate nursing diagnosis for constipation and design effective nursing care plans to address patient needs.

• #67 Constipation Nursing Diagnosis & Care Plan – Nurseslabs

  https://nurseslabs.com/constipation/

  Developing a nursing care plan for constipation requires a thorough understanding of the condition. Learn about constipation and how nurses can improve patient outcomes. Discover assessment, nursing diagnosis, care planning, goal setting, and intervention strategies for constipation nursing care plans. […] Constipation is a common gastrointestinal symptom affecting many individuals and contributes to frequent hospitalizations every year. […] Identifying the underlying cause of constipation is essential to develop an effective nursing care plan that can improve bowel function and relieve symptoms. […] Constipation is a common condition that can be characterized by several signs and symptoms. Identifying these signs and symptoms is critical to develop an accurate nursing diagnosis for constipation and design effective nursing care plans to address patient needs.

• #68 Constipation in Children | WakeMed

  https://www.wakemed.org/care-and-services/gastroenterology/conditions-we-treat/constipation-in-children

  Constipation in Children is defined as: […] Decreased frequency of bowel movements (generally every 3 or more days) […] Stool is harder, making it difficult or painful to pass […] Incomplete evacuation of bowel movement (BM) Cannot pass all of the stool. […] Using the Bristol stool chart will help you tell your doctor the kind of BMs your child is having. It is important for your doctor to know this so he or she can properly diagnose and treat your child. […] Treating constipation is not an exact science. There are several treatment options to meet the unique needs of each child. Commonly used medications are available over the counter. Treatment typically includes diet changes and medications and has two phases a three-day, aggressive, cleanout phase and a maintenance phase. […] Initial approach may include: prune/apple juice 2-3 oz. daily, glycerin suppository, rectal stimulation using Q tip or rectal thermometer, consider limiting dairy intake.

• #69 Constipation Nursing Diagnosis & Care Plan – Nurseslabs

  https://nurseslabs.com/constipation/

  After thorough assessment, nursing diagnoses are formulated to address the challenges of constipation, guided by the nurses clinical judgment and understanding of the patients unique condition. […] Setting goals and expected outcomes is crucial in developing effective nursing care plans for constipation. Common goals include improving bowel function and relieving associated symptoms like abdominal pain and bloating. […] Assessment of the patient with constipation includes a careful history and physical examination, followed by appropriate laboratory and radiological investigations. […] Nursing management of constipation includes relieving the symptoms through nonpharmacological approaches such as dietary changes, lifestyle changes, and physical activity, restoring normal bowel habits, and improving the patients quality of life.

• #70 Nursing Care Plan For Constipation – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-constipation/

  Constipation is a common condition in which an individual has difficulty passing stools or has infrequent bowel movements. This can be caused by a variety of factors, including a low-fiber diet, lack of physical activity, certain medications, or underlying medical conditions. As a nurse, it is important to develop a nursing care plan for constipation to help manage the symptoms and prevent complications. […] The first step in developing a nursing care plan for constipation is to assess the patient. This includes obtaining a complete medical history, including any medications the patient is currently taking, as well as a physical exam to assess the patients bowel movements, diet, and lifestyle habits. […] After conducting a thorough assessment, the nurse can formulate a nursing diagnosis based on the patients needs. Possible nursing diagnoses for constipation include: Constipation related to inadequate fiber intake and inadequate fluid intake, Bowel incontinence related to constipation, Risk for dehydration related to inadequate fluid intake.

• #71 Constipation Nursing Care Plan | Diagnosis, Assessment, Intervention

  https://simplenursing.com/nursing-care-plans/nursing-care-plan-for-constipation/

  Perform […] Abdominal assessment (percussion, palpation, and auscultation) […] Abdominal massage […] Provide […] Adequate privacy […] Assistive equipment for mobility […] Avoid […] Patient pain […] Caffeine and alcohol […] Intolerant foods (i.e. dairy, oils, etc.) […] Administer […] Stool softeners and laxatives as ordered […] Suppositories […] Monitor […] Patient hydration status […] Start a stool chart to keep track of the frequency and kind of bowel motions, establish a baseline, and spot irregularities […] Encourage […] Client to watch defecation warning signs and develop a regular schedule by using a stimulus (such as a warm drink or prune juice). […] Avoidance of long-term use of laxatives and enemas and gradually withdrawing from their use (if used regularly).

• #72 Constipation Nursing Diagnosis & Care Plans | NurseTogether

  https://www.nursetogether.com/constipation-nursing-diagnosis-care-plan/

  The following are the common signs and symptoms of constipation. They are categorized into subjective and objective data based on patient reports. […] The first step of nursing care is the nursing assessment, during which the nurse will gather physical, psychosocial, emotional, and diagnostic data. […] Nursing interventions and care are essential for the patients recovery. […] At least 10% of children with functional constipation require surgical intervention. Surgical treatment aims to evaluate the underlying cause, remove the bowel obstruction, and reduce symptoms. […] Constipation can be caused or worsened by pregnancy, travel, trauma, changes in personal relationships, occupational factors, or financial worries. […] Encourage the patient not to resist or ignore the urge to defecate. Promote predictable interval timing for toileting or colostomy irrigation.

• #73 Constipation in children – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/diagnosis-treatment/drc-20354248

  Hospital enema. Sometimes a child may be so severely constipated that he or she needs to be hospitalized for a short time to be given a stronger enema that will clear the bowel (disimpaction). […] In addition to changes in diet and routine, various alternative approaches may help relieve constipation in children: […] Massage. Gently massaging your child’s abdomen may relax the muscles that support the bladder and intestines, helping to promote bowel activity. […] If your child’s constipation lasts longer than two weeks, you’ll likely first seek medical care from your child’s doctor. […] There are several things you can do that might help relieve your child’s constipation before your doctor’s appointment, for example: […] Give your child prune juice. Prune juice can be mixed with other juices (such as apple juice) if your child doesn’t like the taste.

• #74 Constipation Nursing Care Plan | Diagnosis, Assessment, Intervention

  https://simplenursing.com/nursing-care-plans/nursing-care-plan-for-constipation/

  Perform […] Abdominal assessment (percussion, palpation, and auscultation) […] Abdominal massage […] Provide […] Adequate privacy […] Assistive equipment for mobility […] Avoid […] Patient pain […] Caffeine and alcohol […] Intolerant foods (i.e. dairy, oils, etc.) […] Administer […] Stool softeners and laxatives as ordered […] Suppositories […] Monitor […] Patient hydration status […] Start a stool chart to keep track of the frequency and kind of bowel motions, establish a baseline, and spot irregularities […] Encourage […] Client to watch defecation warning signs and develop a regular schedule by using a stimulus (such as a warm drink or prune juice). […] Avoidance of long-term use of laxatives and enemas and gradually withdrawing from their use (if used regularly).

• #75 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Management of constipation includes dietary modifications, behavior interventions, medications, and disimpaction if needed. Treatment does not differ for preschool-aged children, older children, and adolescents. […] Quality of life scores are lower in children with chronic constipation than those without constipation. Children with functional constipation may experience shame, peer rejection, bullying, and recurrent treatment failures. Adolescents with functional constipation are at increased risk of depression, anxiety, somatic symptoms, withdrawal, and social problems. Current evidence does not support intensive behavior therapy or biofeedback in the treatment of functional constipation. However, minor behavior modifications such as structured toilet training with a reward system, in which the child is instructed to defecate after each meal, may prevent recurrence of fecal impaction.

• #76 Constipation Nursing Care Plan | Diagnosis, Assessment, Intervention

  https://simplenursing.com/nursing-care-plans/nursing-care-plan-for-constipation/

  Perform […] Abdominal assessment (percussion, palpation, and auscultation) […] Abdominal massage […] Provide […] Adequate privacy […] Assistive equipment for mobility […] Avoid […] Patient pain […] Caffeine and alcohol […] Intolerant foods (i.e. dairy, oils, etc.) […] Administer […] Stool softeners and laxatives as ordered […] Suppositories […] Monitor […] Patient hydration status […] Start a stool chart to keep track of the frequency and kind of bowel motions, establish a baseline, and spot irregularities […] Encourage […] Client to watch defecation warning signs and develop a regular schedule by using a stimulus (such as a warm drink or prune juice). […] Avoidance of long-term use of laxatives and enemas and gradually withdrawing from their use (if used regularly).

• #77 Pediatric Functional Constipation | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/21993

  Normal fiber and fluid intake are recommended for children with constipation, along with an average amount of physical activity. […] Deterrence and patient education play pivotal roles in addressing pediatric functional constipation. […] Identifying pediatric functional constipation requires a thorough understanding of common symptoms such as infrequent, painful bowel movements and hard stools. […] The disposition in pediatric functional constipation involves a multidisciplinary approach. […] Successful treatment of functional constipation requires an interprofessional team approach.

• #78 Paediatric constipation | Nursing Times

  https://www.nursingtimes.net/bladder-and-bowel/paediatric-constipation-18-11-2003/

  – 5-10 per cent of children are thought to have constipation (Leung et al, 1996). […] – High-fibre diet with plenty of liquid is the first-line treatment. […] – Laxatives may be required if diet does not work, or the child has severe constipation or a large impacted stool. […] – If constipation is chronic it is essential to achieve colonic evacuation before starting maintenance laxative therapy. […] – Laxatives are usually required for several months. They are used to clear impacted stools; encourage the child to go to the toilet more regularly; enable the enlarged rectum to return to normal size. […] – Referral to a paediatrician may be required if: constipation is severe and intractable; Hirschsprungs disease is suspected; there is severe family distress; there is blood in the stool and/or anal pain after six weeks of treatment; constipation does not resolve after three months of treatment. […] – Referral to a child psychiatrist may be necessary if there is evidence of psychological disturbance. […] – Referral to a dietitian may be helpful if the child experiences major dietary problems.

• #79 Constipation in children and young people: diagnosis and management – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554924/

  Assess all children and young people with idiopathic constipation for faecal impaction, including children and young people who were originally referred to the relevant services because of red flags but in whom there were no significant findings following further investigations. […] Offer the following oral medication regimen for disimpaction if indicated: Polyethylene glycol 3350 + electrolytes, using an escalating dose regimen, as the first-line treatment. […] Do not use dietary interventions alone as first-line treatment for idiopathic constipation. […] Offer children and young people with idiopathic constipation and their families a point of contact with specialist healthcare professionals, including school nurses, who can give ongoing support.

• #80 Constipation Nursing Diagnosis & Care Plan – Nurseslabs

  https://nurseslabs.com/constipation/

  Laxatives are recommended when nonpharmacological measures such as behavioral modification and diet are ineffective in managing constipation. However, the use of laxatives must be individualized with extra caution for older adults due to existing cardiac and renal conditions, adverse effects, and potential drug interactions. […] Surgical interventions such as sigmoid colectomy, ileostomy, and ileorectal anastomosis are an alternative option for clients with chronic and severe constipation who are unresponsive to other forms of medical treatments and those clients with refractory slow transit constipation, specifically colonic inertia.

• #81 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation. Fecal impaction can be diagnosed by a history of overflow soiling, the presence of a palpable fecal mass during an abdominal examination, or hard stool in a dilated rectum if a digital rectal examination is warranted. Disimpaction can be achieved by using oral or rectal medications. Polyethylene glycol (Miralax) is a polymer that is minimally absorbed by the gastrointestinal tract, leading to water retention in the intestine and softened stools. Polyethylene glycol is the first-line treatment because it is more effective than other agents for disimpaction and maintenance therapy, is well-tolerated, and has a low risk of adverse effects. […] Maintenance therapy should be started in children without impaction or when disimpaction is achieved. The goals of maintenance therapy are to achieve soft stool daily or every other day and to prevent stool impaction. Polyethylene glycol is superior to other oral laxatives and is recommended as a first-line maintenance treatment for constipation. The starting maintenance dosage of polyethylene glycol is 0.4 g per kg per day, and caregivers should be advised that it can be increased or decreased to maintain soft stool every day or every other day without diarrhea. Polyethylene glycol appears to be safe for long-term use in children.

• #82 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation. Fecal impaction can be diagnosed by a history of overflow soiling, the presence of a palpable fecal mass during an abdominal examination, or hard stool in a dilated rectum if a digital rectal examination is warranted. Disimpaction can be achieved by using oral or rectal medications. Polyethylene glycol (Miralax) is a polymer that is minimally absorbed by the gastrointestinal tract, leading to water retention in the intestine and softened stools. Polyethylene glycol is the first-line treatment because it is more effective than other agents for disimpaction and maintenance therapy, is well-tolerated, and has a low risk of adverse effects. […] Maintenance therapy should be started in children without impaction or when disimpaction is achieved. The goals of maintenance therapy are to achieve soft stool daily or every other day and to prevent stool impaction. Polyethylene glycol is superior to other oral laxatives and is recommended as a first-line maintenance treatment for constipation. The starting maintenance dosage of polyethylene glycol is 0.4 g per kg per day, and caregivers should be advised that it can be increased or decreased to maintain soft stool every day or every other day without diarrhea. Polyethylene glycol appears to be safe for long-term use in children.

• #83 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. Polyethylene glycol is the first-line treatment for constipation. Second-line options include lactulose and enemas. Increasing dietary fiber and fluid intake above usual daily recommendations and adding probiotics provide no additional benefits for treating constipation. Frequent follow-up visits and referrals to a psychologist can assist in reaching some treatment goals. Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers’ specific challenges and the negative effects of constipation on the child’s quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #84 Home Remedies for Constipation in Kids

  https://www.unitypoint.org/news-and-articles/home-remedies-for-constipation-in-kids

  Use natural laxatives. Foods that help with constipation in kids include prunes, apples and pears. They’re nature’s laxatives. These fruits contain a sugar called „sorbitol,” which draws water into the bowels and softens the stool. Offer these foods with water to help with easier bowel movements. […] Increase water. Water intake (for children older than one) keeps the body hydrated, which also makes passing stools easier. Getting enough water helps prevent constipation and promotes regularity. […] Increase fiber. Feed your child a diet rich in fiber by aiming for five servings of fruits and vegetables each day. […] Decrease dairy. Excess dairy intake, especially milk, can cause constipation. Many children have a sensitivity to the proteins found in cow’s milk. […] Provide stress free potty breaks. Constipated children may take a much longer time in the bathroom to have a bowel movement. Ensure good bowel habits by having their feet supported on a stool, or the floor if they can reach.

• #85 Constipation in infants and children: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/003125.htm

  Lifestyle changes can help your child avoid constipation. These changes can also be used to treat it. […] For infants: Give your baby extra water or juice during the day in between feedings. Juice can help bring water to the colon. […] For children: Drink plenty of fluids each day. Your child’s health care provider can tell you how much. Eat more fruits and vegetables and foods high in fiber, such as whole grains. […] Stool softeners (such as those containing docusate sodium) may help for older children. Bulk laxatives such as psyllium may help add fluid and bulk to the stool. […] Contact your child’s provider right away if: An infant (except those who are only breastfed) goes 3 days without a stool and is vomiting or irritable. […] The provider may recommend the use of stool softeners or laxatives. If stools are impacted, glycerin suppositories or saline enemas may be recommended also.

• #86 Constipation in infants and children: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/003125.htm

  Lifestyle changes can help your child avoid constipation. These changes can also be used to treat it. […] For infants: Give your baby extra water or juice during the day in between feedings. Juice can help bring water to the colon. […] For children: Drink plenty of fluids each day. Your child’s health care provider can tell you how much. Eat more fruits and vegetables and foods high in fiber, such as whole grains. […] Stool softeners (such as those containing docusate sodium) may help for older children. Bulk laxatives such as psyllium may help add fluid and bulk to the stool. […] Contact your child’s provider right away if: An infant (except those who are only breastfed) goes 3 days without a stool and is vomiting or irritable. […] The provider may recommend the use of stool softeners or laxatives. If stools are impacted, glycerin suppositories or saline enemas may be recommended also.

• #87 Constipation in children – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/diagnosis-treatment/drc-20354248

  Your child’s doctor will: […] Conduct a physical exam. Your child’s physical exam will likely include placing a gloved finger into your child’s anus to check for abnormalities or the presence of impacted stool. Stool found in the rectum may be tested for blood. […] Depending on the circumstances, your child’s doctor may recommend: […] Over-the-counter fiber supplements or stool softeners. If your child doesn’t get a lot of fiber in his or her diet, adding an over-the-counter fiber supplement, such as Metamucil or Citrucel, might help. […] Glycerin suppositories can be used to soften the stool in children who can’t swallow pills. Talk with your child’s doctor about the right way to use these products. […] A laxative or enema. If an accumulation of fecal material creates a blockage, your child’s doctor may suggest a laxative or enema to help remove the blockage.

• #88

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  It is important to note that fiber supplements taken without enough water can worsen your child’s constipation! […] Children sometimes have bad posture on the toilet: they slump at the waist and do not sit up straight, they cross their legs, their legs dangle in the air or they clinch their bottom cheeks together. […] One tool to improve toilet posture is the defecation posture modification device, a potty stool. This kind of stool can improve toileting posture by promoting the relaxation of the puborectalis muscle and straightening of the „ano-rectal” angle to make passing a poop easier. […] There are many laxative medicines available to treat children with functional constipation including stool softeners, osmotic laxatives, stimulant laxatives, secretagogue laxatives and rectal therapies.

• #89 Constipation Nursing Diagnosis & Care Plans | NurseTogether

  https://www.nursetogether.com/constipation-nursing-diagnosis-care-plan/

  Constipation is a common side effect of opioids. Reassure the patient that this concern is addressable through intake of a stimulant (senna/bisacodyl), stool softener (docusate), or an osmotic laxative (polyethylene glycol) accompanied by physical mobility after surgery. […] Dietary fiber increases the size and softens the consistency of stool. Hence, it promotes easier stool elimination and maintains bowel health.

• #90 Constipation Nursing Diagnosis & Care Plans | NurseTogether

  https://www.nursetogether.com/constipation-nursing-diagnosis-care-plan/

  Constipation is a common side effect of opioids. Reassure the patient that this concern is addressable through intake of a stimulant (senna/bisacodyl), stool softener (docusate), or an osmotic laxative (polyethylene glycol) accompanied by physical mobility after surgery. […] Dietary fiber increases the size and softens the consistency of stool. Hence, it promotes easier stool elimination and maintains bowel health.

• #91 Constipation in children – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/diagnosis-treatment/drc-20354248

  Your child’s doctor will: […] Conduct a physical exam. Your child’s physical exam will likely include placing a gloved finger into your child’s anus to check for abnormalities or the presence of impacted stool. Stool found in the rectum may be tested for blood. […] Depending on the circumstances, your child’s doctor may recommend: […] Over-the-counter fiber supplements or stool softeners. If your child doesn’t get a lot of fiber in his or her diet, adding an over-the-counter fiber supplement, such as Metamucil or Citrucel, might help. […] Glycerin suppositories can be used to soften the stool in children who can’t swallow pills. Talk with your child’s doctor about the right way to use these products. […] A laxative or enema. If an accumulation of fecal material creates a blockage, your child’s doctor may suggest a laxative or enema to help remove the blockage.

• #92 Constipation in children – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/diagnosis-treatment/drc-20354248

  Your child’s doctor will: […] Conduct a physical exam. Your child’s physical exam will likely include placing a gloved finger into your child’s anus to check for abnormalities or the presence of impacted stool. Stool found in the rectum may be tested for blood. […] Depending on the circumstances, your child’s doctor may recommend: […] Over-the-counter fiber supplements or stool softeners. If your child doesn’t get a lot of fiber in his or her diet, adding an over-the-counter fiber supplement, such as Metamucil or Citrucel, might help. […] Glycerin suppositories can be used to soften the stool in children who can’t swallow pills. Talk with your child’s doctor about the right way to use these products. […] A laxative or enema. If an accumulation of fecal material creates a blockage, your child’s doctor may suggest a laxative or enema to help remove the blockage.

• #93 Home Remedies for Constipation in Kids

  https://www.unitypoint.org/news-and-articles/home-remedies-for-constipation-in-kids

  When it comes to giving your child products or over-the-counter medication to help with constipation, Dr. Granger says you should first talk to your child’s provider. […] Probiotics are often used for pediatric patients, especially while on antibiotics. […] Suppositories help stimulate rectal muscles to encourage a bowel movement but can be uncomfortable for the child when inserted and, if not done correctly, can cause rectal trauma. […] MiraLAX is a good medication for constipation, both acute and chronic, when used correctly in children over one year old. […] If your child is experiencing any of the following, Dr. Granger says it’s important to have them seen by their doctor: Blood in the stool, Vomiting associated with the constipation, Severe abdominal pain, Children over the age of one not having daily soft stools despite home remedies.

• #94 Constipation in Children: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.constipation-in-children-care-instructions.ut1883

  For children 1 year or older, give your child plenty of water and other fluids. Include high-fiber foods like fruits, vegetables, beans, or whole grains in your child’s diet each day. Have your child take medicines exactly as prescribed. Call your doctor if you think your child is having a problem with a medicine. Make sure your child gets daily exercise. It helps the body have regular bowel movements. Tell your child to go to the bathroom when they have the urge. Do not give laxatives or enemas to your child unless your child’s doctor recommends it. Make a routine of putting your child on the toilet or potty chair after the same meal each day. […] Call your doctor now or seek immediate medical care if there is blood in your child’s stool, your child has severe belly pain, or your child is vomiting. Watch closely for changes in your child’s health, and be sure to contact your doctor if your child’s constipation gets worse.

• #95 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation. Fecal impaction can be diagnosed by a history of overflow soiling, the presence of a palpable fecal mass during an abdominal examination, or hard stool in a dilated rectum if a digital rectal examination is warranted. Disimpaction can be achieved by using oral or rectal medications. Polyethylene glycol (Miralax) is a polymer that is minimally absorbed by the gastrointestinal tract, leading to water retention in the intestine and softened stools. Polyethylene glycol is the first-line treatment because it is more effective than other agents for disimpaction and maintenance therapy, is well-tolerated, and has a low risk of adverse effects. […] Maintenance therapy should be started in children without impaction or when disimpaction is achieved. The goals of maintenance therapy are to achieve soft stool daily or every other day and to prevent stool impaction. Polyethylene glycol is superior to other oral laxatives and is recommended as a first-line maintenance treatment for constipation. The starting maintenance dosage of polyethylene glycol is 0.4 g per kg per day, and caregivers should be advised that it can be increased or decreased to maintain soft stool every day or every other day without diarrhea. Polyethylene glycol appears to be safe for long-term use in children.

• #96

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut1883

  Your child’s doctor may recommend adding more fibre to your child’s diet after constipation has been treated successfully. This is important to keep their bowels healthy and prevent constipation. […] Treating chronic constipation in children takes time. It takes at least several months to allow all these steps to work, set up new and healthy habits, and prevent constipation from coming back. Always follow the instructions from your child’s doctor. Never stop medicines suddenly, because your child needs to wean off medicines gradually. […] Call your doctor or nurse advice line now or seek immediate medical care if there is blood in your child’s stool, your child has severe belly pain, or your child is vomiting. Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if your child’s constipation gets worse.

• #97 Constipation Nursing Care Plan | Diagnosis, Assessment, Intervention

  https://simplenursing.com/nursing-care-plans/nursing-care-plan-for-constipation/

  Perform […] Abdominal assessment (percussion, palpation, and auscultation) […] Abdominal massage […] Provide […] Adequate privacy […] Assistive equipment for mobility […] Avoid […] Patient pain […] Caffeine and alcohol […] Intolerant foods (i.e. dairy, oils, etc.) […] Administer […] Stool softeners and laxatives as ordered […] Suppositories […] Monitor […] Patient hydration status […] Start a stool chart to keep track of the frequency and kind of bowel motions, establish a baseline, and spot irregularities […] Encourage […] Client to watch defecation warning signs and develop a regular schedule by using a stimulus (such as a warm drink or prune juice). […] Avoidance of long-term use of laxatives and enemas and gradually withdrawing from their use (if used regularly).

• #98

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut1883

  Your child’s doctor may recommend adding more fibre to your child’s diet after constipation has been treated successfully. This is important to keep their bowels healthy and prevent constipation. […] Treating chronic constipation in children takes time. It takes at least several months to allow all these steps to work, set up new and healthy habits, and prevent constipation from coming back. Always follow the instructions from your child’s doctor. Never stop medicines suddenly, because your child needs to wean off medicines gradually. […] Call your doctor or nurse advice line now or seek immediate medical care if there is blood in your child’s stool, your child has severe belly pain, or your child is vomiting. Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if your child’s constipation gets worse.

• #99 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation. Fecal impaction can be diagnosed by a history of overflow soiling, the presence of a palpable fecal mass during an abdominal examination, or hard stool in a dilated rectum if a digital rectal examination is warranted. Disimpaction can be achieved by using oral or rectal medications. Polyethylene glycol (Miralax) is a polymer that is minimally absorbed by the gastrointestinal tract, leading to water retention in the intestine and softened stools. Polyethylene glycol is the first-line treatment because it is more effective than other agents for disimpaction and maintenance therapy, is well-tolerated, and has a low risk of adverse effects. […] Maintenance therapy should be started in children without impaction or when disimpaction is achieved. The goals of maintenance therapy are to achieve soft stool daily or every other day and to prevent stool impaction. Polyethylene glycol is superior to other oral laxatives and is recommended as a first-line maintenance treatment for constipation. The starting maintenance dosage of polyethylene glycol is 0.4 g per kg per day, and caregivers should be advised that it can be increased or decreased to maintain soft stool every day or every other day without diarrhea. Polyethylene glycol appears to be safe for long-term use in children.

• #100 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Management of constipation includes dietary modifications, behavior interventions, medications, and disimpaction if needed. Treatment does not differ for preschool-aged children, older children, and adolescents. […] Quality of life scores are lower in children with chronic constipation than those without constipation. Children with functional constipation may experience shame, peer rejection, bullying, and recurrent treatment failures. Adolescents with functional constipation are at increased risk of depression, anxiety, somatic symptoms, withdrawal, and social problems. Current evidence does not support intensive behavior therapy or biofeedback in the treatment of functional constipation. However, minor behavior modifications such as structured toilet training with a reward system, in which the child is instructed to defecate after each meal, may prevent recurrence of fecal impaction.

• #101 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Management of constipation includes dietary modifications, behavior interventions, medications, and disimpaction if needed. Treatment does not differ for preschool-aged children, older children, and adolescents. […] Quality of life scores are lower in children with chronic constipation than those without constipation. Children with functional constipation may experience shame, peer rejection, bullying, and recurrent treatment failures. Adolescents with functional constipation are at increased risk of depression, anxiety, somatic symptoms, withdrawal, and social problems. Current evidence does not support intensive behavior therapy or biofeedback in the treatment of functional constipation. However, minor behavior modifications such as structured toilet training with a reward system, in which the child is instructed to defecate after each meal, may prevent recurrence of fecal impaction.

• #102 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Management of constipation includes dietary modifications, behavior interventions, medications, and disimpaction if needed. Treatment does not differ for preschool-aged children, older children, and adolescents. […] Quality of life scores are lower in children with chronic constipation than those without constipation. Children with functional constipation may experience shame, peer rejection, bullying, and recurrent treatment failures. Adolescents with functional constipation are at increased risk of depression, anxiety, somatic symptoms, withdrawal, and social problems. Current evidence does not support intensive behavior therapy or biofeedback in the treatment of functional constipation. However, minor behavior modifications such as structured toilet training with a reward system, in which the child is instructed to defecate after each meal, may prevent recurrence of fecal impaction.

• #103 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Management of constipation includes dietary modifications, behavior interventions, medications, and disimpaction if needed. Treatment does not differ for preschool-aged children, older children, and adolescents. […] Quality of life scores are lower in children with chronic constipation than those without constipation. Children with functional constipation may experience shame, peer rejection, bullying, and recurrent treatment failures. Adolescents with functional constipation are at increased risk of depression, anxiety, somatic symptoms, withdrawal, and social problems. Current evidence does not support intensive behavior therapy or biofeedback in the treatment of functional constipation. However, minor behavior modifications such as structured toilet training with a reward system, in which the child is instructed to defecate after each meal, may prevent recurrence of fecal impaction.

• #104 Constipation and children | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation-and-children

  See a doctor if constipation is a long-term problem. […] A healthy diet is very important. […] Suggestions to treat constipation in babies include: If your baby is bottle-fed, check the formula tin to make sure the formula is being made correctly. […] Offer extra drinks of water. […] Gentle tummy massage can help. […] Give only medication prescribed by your doctor. […] There are no health problems from occasional bouts of constipation. However, if the constipation lasts for a long time and a large mass of poo (faeces) is held in the gut, soiling may begin. This can lead to serious social and emotional problems.

• #105 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Management of constipation includes dietary modifications, behavior interventions, medications, and disimpaction if needed. Treatment does not differ for preschool-aged children, older children, and adolescents. […] Quality of life scores are lower in children with chronic constipation than those without constipation. Children with functional constipation may experience shame, peer rejection, bullying, and recurrent treatment failures. Adolescents with functional constipation are at increased risk of depression, anxiety, somatic symptoms, withdrawal, and social problems. Current evidence does not support intensive behavior therapy or biofeedback in the treatment of functional constipation. However, minor behavior modifications such as structured toilet training with a reward system, in which the child is instructed to defecate after each meal, may prevent recurrence of fecal impaction.

• #106 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Management of constipation includes dietary modifications, behavior interventions, medications, and disimpaction if needed. Treatment does not differ for preschool-aged children, older children, and adolescents. […] Quality of life scores are lower in children with chronic constipation than those without constipation. Children with functional constipation may experience shame, peer rejection, bullying, and recurrent treatment failures. Adolescents with functional constipation are at increased risk of depression, anxiety, somatic symptoms, withdrawal, and social problems. Current evidence does not support intensive behavior therapy or biofeedback in the treatment of functional constipation. However, minor behavior modifications such as structured toilet training with a reward system, in which the child is instructed to defecate after each meal, may prevent recurrence of fecal impaction.

• #107 Constipation in Children | WakeMed

  https://www.wakemed.org/care-and-services/gastroenterology/conditions-we-treat/constipation-in-children

  If the above approaches do not work by themselves, consider adding one of the following medications. Before you do, talk to your child’s doctor. It is important to include your child’s doctor in medical decision-making. […] Limit dairy intake, High fiber diet (age + 5 grams daily) use soluble fibers such as psyllium husk, Drink plenty of water, Avoid withholding behavior, Scheduled toilet times before school, after every meal, Encourage using bathrooms in school. […] If no success add a stimulant medication (twice a week). […] Patients with purposeful withholding behavior due to control issues referral to psychologist or behavioral therapist. […] It may take a few days for the treatment to work. Contact your child’s doctor if you have questions or you do not feel the treatment is working after several days.

• #108 Nursing Care Plan (NCP) for Constipation / Encopresis | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-constipation-encopresis

  Both constipation and encopresis can be uncomfortable and embarrassing, but there are ways to help, like changing what you eat, getting more exercise, and sometimes taking medicine. Its also important for kids with encopresis to know its not their fault and theyre not alone. With the right care and support, they can feel better. […] A comprehensive nursing assessment is foundational for understanding the nuances of constipation. […] When assessing encopresis, the focus extends beyond the physical symptoms to include psychosocial elements. […] The primary goal is to achieve regular and predictable bowel movements. This involves addressing factors such as dietary habits, fluid intake, and physical activity to support healthy bowel function. […] The warm water helps to relax the muscles in the rectum and soothe the perianal area.

• #109

  https://www2.hse.ie/conditions/constipation-children/

  Constipation is when your child has a hard bowel movement, and it is difficult for them to poo. […] Constipation is common and it affects children of all ages. […] If you think your child may be constipated, take them to your GP. The treatment for constipation depends on your child’s age. […] The longer your child is constipated, the more difficult it can be for them to get back to normal. Make sure you get help early. […] Diet, lifestyle changes and laxatives are often recommended for children who are eating solid foods. […] When our child’s constipation has been treated, it’s important to stop it coming back. Your GP may recommend your child keeps taking laxatives for a while to make sure their poo stays soft enough to push out regularly. […] Being constipated and soiling their clothes is not something your child does on purpose. There’s no reason to get cross with them.

• #110 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. Polyethylene glycol is the first-line treatment for constipation. Second-line options include lactulose and enemas. Increasing dietary fiber and fluid intake above usual daily recommendations and adding probiotics provide no additional benefits for treating constipation. Frequent follow-up visits and referrals to a psychologist can assist in reaching some treatment goals. Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers’ specific challenges and the negative effects of constipation on the child’s quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #111 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. Polyethylene glycol is the first-line treatment for constipation. Second-line options include lactulose and enemas. Increasing dietary fiber and fluid intake above usual daily recommendations and adding probiotics provide no additional benefits for treating constipation. Frequent follow-up visits and referrals to a psychologist can assist in reaching some treatment goals. Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers’ specific challenges and the negative effects of constipation on the child’s quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #112 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. Polyethylene glycol is the first-line treatment for constipation. Second-line options include lactulose and enemas. Increasing dietary fiber and fluid intake above usual daily recommendations and adding probiotics provide no additional benefits for treating constipation. Frequent follow-up visits and referrals to a psychologist can assist in reaching some treatment goals. Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers’ specific challenges and the negative effects of constipation on the child’s quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #113 Constipation in children and young people: diagnosis and management – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554924/

  This guideline offers best practice advice on the care of children and young people with idiopathic constipation. […] Treatment and care should take into account patients needs and preferences. Children and young people with idiopathic constipation and their parents and carers should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. […] Good communication between healthcare professionals and patients is essential. […] Families and carers should also be given the information and support they need. […] Adult and paediatric healthcare teams should work jointly to provide assessment and services to young people with idiopathic constipation. Diagnosis and management should be reviewed throughout the transition process, and there should be clarity about who is the lead clinician to ensure continuity of care.

• #114 Constipation in Children: Symptoms, Treatment and Resources | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/constipation

  Children with soiling or more severe constipation usually require medication. […] Once your child is having soft, comfortable bowel movements on a regular basis, the next step is to get their regular toileting schedule back on track. […] Our team includes behavioral specialists who provide additional care for patients with encopresis. These specialists help your child: Get a regular toileting routine started, Have less anxiety around having a bowel movement, Reduce their stool withholding behavior, Have less conflict with their parents over the problem, Feel that they are part of the treatment team.

• #115 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children and adolescents is defined as passing delayed or infrequent hard stools with pain and excessive straining. The prevalence of constipation in children and adolescents is estimated to be as high as 30% worldwide. Constipation in children accounts for 3% of primary care physician visits and up to 25% of referrals to pediatric gastroenterologists. Children with constipation incur three times the health care costs of children without constipation, and chronic constipation can have a negative effect on the child’s quality of life. […] Functional constipation is diagnosed by history and physical examination findings in patients without red flag signs or symptoms. Digital rectal examination and abdominal radiography should not be performed routinely in children with suspected functional constipation. Increasing fiber or fluid intake above usual daily recommendations does not improve constipation in children. Probiotics are not beneficial in the treatment of constipation in children. Referring children with functional constipation to a child psychologist can improve some constipation outcomes. Polyethylene glycol (Miralax) is first-line treatment for functional constipation in children.

• #116 Constipation in Children: Symptoms, Treatment and Resources | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/constipation

  Children with soiling or more severe constipation usually require medication. […] Once your child is having soft, comfortable bowel movements on a regular basis, the next step is to get their regular toileting schedule back on track. […] Our team includes behavioral specialists who provide additional care for patients with encopresis. These specialists help your child: Get a regular toileting routine started, Have less anxiety around having a bowel movement, Reduce their stool withholding behavior, Have less conflict with their parents over the problem, Feel that they are part of the treatment team.

• #117 Constipation in Children: Symptoms, Treatment and Resources | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/constipation

  Children with soiling or more severe constipation usually require medication. […] Once your child is having soft, comfortable bowel movements on a regular basis, the next step is to get their regular toileting schedule back on track. […] Our team includes behavioral specialists who provide additional care for patients with encopresis. These specialists help your child: Get a regular toileting routine started, Have less anxiety around having a bowel movement, Reduce their stool withholding behavior, Have less conflict with their parents over the problem, Feel that they are part of the treatment team.

• #118 Constipation in Children: Symptoms, Treatment and Resources | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/constipation

  Children with soiling or more severe constipation usually require medication. […] Once your child is having soft, comfortable bowel movements on a regular basis, the next step is to get their regular toileting schedule back on track. […] Our team includes behavioral specialists who provide additional care for patients with encopresis. These specialists help your child: Get a regular toileting routine started, Have less anxiety around having a bowel movement, Reduce their stool withholding behavior, Have less conflict with their parents over the problem, Feel that they are part of the treatment team.

• #119 Constipation in Children: Symptoms, Treatment and Resources | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/constipation

  Children with soiling or more severe constipation usually require medication. […] Once your child is having soft, comfortable bowel movements on a regular basis, the next step is to get their regular toileting schedule back on track. […] Our team includes behavioral specialists who provide additional care for patients with encopresis. These specialists help your child: Get a regular toileting routine started, Have less anxiety around having a bowel movement, Reduce their stool withholding behavior, Have less conflict with their parents over the problem, Feel that they are part of the treatment team.

• #120 Constipation in Children: Symptoms, Treatment and Resources | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/constipation

  Children with soiling or more severe constipation usually require medication. […] Once your child is having soft, comfortable bowel movements on a regular basis, the next step is to get their regular toileting schedule back on track. […] Our team includes behavioral specialists who provide additional care for patients with encopresis. These specialists help your child: Get a regular toileting routine started, Have less anxiety around having a bowel movement, Reduce their stool withholding behavior, Have less conflict with their parents over the problem, Feel that they are part of the treatment team.

• #121 Paediatric constipation | Nursing Times

  https://www.nursingtimes.net/bladder-and-bowel/paediatric-constipation-18-11-2003/

  – 5-10 per cent of children are thought to have constipation (Leung et al, 1996). […] – High-fibre diet with plenty of liquid is the first-line treatment. […] – Laxatives may be required if diet does not work, or the child has severe constipation or a large impacted stool. […] – If constipation is chronic it is essential to achieve colonic evacuation before starting maintenance laxative therapy. […] – Laxatives are usually required for several months. They are used to clear impacted stools; encourage the child to go to the toilet more regularly; enable the enlarged rectum to return to normal size. […] – Referral to a paediatrician may be required if: constipation is severe and intractable; Hirschsprungs disease is suspected; there is severe family distress; there is blood in the stool and/or anal pain after six weeks of treatment; constipation does not resolve after three months of treatment. […] – Referral to a child psychiatrist may be necessary if there is evidence of psychological disturbance. […] – Referral to a dietitian may be helpful if the child experiences major dietary problems.

• #122 Narrative review of constipation in the critically ill child – López – Pediatric Medicine

  https://pm.amegroups.org/article/view/6052/html

  Constipation is a common but understudied complication in the critically ill child. Its diagnosis is frequently delayed because it is not usually considered to be such a severe complication for these patients. However, constipation has been associated with worse outcomes in critically ill adults and children. […] Constipation in the critically ill child is a poorly studied disease which can represent up to 50% of children admitted to Pediatric Intensive Care Units (PICU). […] Constipation is frequently diagnosed only after secondary complications are present, and at this point, constipation is more difficult to manage. […] Constipation symptoms in the pediatric critically ill patient depend on severity and time from illness onset. At the beginning, clinical findings are very similar to functional constipation with no bowel movements, abdominal pain and distension.

• #123 Toddler Constipation: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17785-constipation-in-children

  Constipation in toddlers is very common. Toddlers who are constipated poop (have a bowel movement) less frequently than usual. Every toddler is different, but this usually means they poop less than two times a week. When they do go, their poop (stool) is hard, dry and large in size. Their poop may be difficult or painful to pass. […] Constipation in toddlers usually doesn’t last for long. But avoiding pooping can lead to: Fecal impaction: Hard stool packs your child’s intestine and rectum too tightly for them to push out. Encopresis: The inability to regulate the passage of stool, which leads to accidents. Anal fissures: Small tears in your child’s anus that cause bleeding, itching or pain. Rectal prolapse: Your child’s rectum sticks out of their anus. Hemorrhoids: Swollen veins inside of your child’s rectum or outside of their anus.

• #124 Constipation and children | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation-and-children

  Some children ignore the urge to go to the toilet because they are too busy playing. […] Some children hold back when they are being toilet trained. […] Some children dont want to use school or preschool toilets for various reasons, such as lack of privacy or a smelly toilet. […] The child may not be getting enough exercise. […] Some of the signs of constipation in children include: saying that it hurts when doing a poo, showing signs of holding on such as crossing legs, running around, crying or refusing to sit on the toilet, complaining of tummy pain, soiling their pants (with ongoing constipation). […] Suggestions for treating constipation in children include: Encourage your child to exercise more. […] Establish a regular toilet routine. […] Limit the use of laxatives. […] Try to solve the problem quickly the longer your child remains constipated, the worse it may become and the longer it may take to treat.

• #125 Toddler Constipation: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17785-constipation-in-children

  Constipation in toddlers is very common. Toddlers who are constipated poop (have a bowel movement) less frequently than usual. Every toddler is different, but this usually means they poop less than two times a week. When they do go, their poop (stool) is hard, dry and large in size. Their poop may be difficult or painful to pass. […] Constipation in toddlers usually doesn’t last for long. But avoiding pooping can lead to: Fecal impaction: Hard stool packs your child’s intestine and rectum too tightly for them to push out. Encopresis: The inability to regulate the passage of stool, which leads to accidents. Anal fissures: Small tears in your child’s anus that cause bleeding, itching or pain. Rectal prolapse: Your child’s rectum sticks out of their anus. Hemorrhoids: Swollen veins inside of your child’s rectum or outside of their anus.

• #126 Toddler Constipation: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17785-constipation-in-children

  Constipation in toddlers is very common. Toddlers who are constipated poop (have a bowel movement) less frequently than usual. Every toddler is different, but this usually means they poop less than two times a week. When they do go, their poop (stool) is hard, dry and large in size. Their poop may be difficult or painful to pass. […] Constipation in toddlers usually doesn’t last for long. But avoiding pooping can lead to: Fecal impaction: Hard stool packs your child’s intestine and rectum too tightly for them to push out. Encopresis: The inability to regulate the passage of stool, which leads to accidents. Anal fissures: Small tears in your child’s anus that cause bleeding, itching or pain. Rectal prolapse: Your child’s rectum sticks out of their anus. Hemorrhoids: Swollen veins inside of your child’s rectum or outside of their anus.

• #127 Toddler Constipation: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17785-constipation-in-children

  Constipation in toddlers is very common. Toddlers who are constipated poop (have a bowel movement) less frequently than usual. Every toddler is different, but this usually means they poop less than two times a week. When they do go, their poop (stool) is hard, dry and large in size. Their poop may be difficult or painful to pass. […] Constipation in toddlers usually doesn’t last for long. But avoiding pooping can lead to: Fecal impaction: Hard stool packs your child’s intestine and rectum too tightly for them to push out. Encopresis: The inability to regulate the passage of stool, which leads to accidents. Anal fissures: Small tears in your child’s anus that cause bleeding, itching or pain. Rectal prolapse: Your child’s rectum sticks out of their anus. Hemorrhoids: Swollen veins inside of your child’s rectum or outside of their anus.

• #128 Constipation in Children: Causes, Signs & Treatment | CHOC

  https://choc.org/programs-services/gastroenterology/constipation/

  Although each child may experience constipation differently, symptoms can include: Less than three bowel movements per week, At least one episode of stool leakage per week, Withholding behavior: A child actively tries not to go the bathroom. […] Mild constipation may be treated with dietary changes. Increased fiber in the diet along with normal water or fluid intake may soften the stools. […] Treatment of children with chronic constipation is necessary to reduce their risk of developing other complications such as: Hemorrhoids, which occur by straining to have a bowel movement, Anal fissures (tears in the skin around the anus), which occur when hard stool stretches the sphincter muscle. […] The best way to start off treatment of a constipated child is to evacuate the old stool from the rectum and colon.

• #129

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  Sometimes, a withholding cycle when the child holds in the poop day after day can cause more severe symptoms like intense abdominal pain (stomach aches) or bloating, decreased appetite, nausea or reflux, diarrhea from bowel overflow. […] When poop overflows like diarrhea because of constipation, we call this encopresis. Encopresis can be very alarming to children and parents because it can look like diarrhea caused by infections. However, it is actually the child’s body attempting to evacuate a large amount of poop. […] The large, rocky hard poops caused by constipation can cause injury to the skin around the rectum and anus when a child finally has a poop. This can lead to pain with pooping, but the hard poops can also tear the skin around the rectum. This can cause bleeding. […] Many treatments and strategies exist to help children manage their constipation. While some of these medicines are over the counter, we recommend that you discuss any treatments with your child’s doctor before starting.

• #130 Constipation and children | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation-and-children

  Constipation is the passing of a hard bowel motion (poo) with pain and discomfort. […] Common causes of constipation include lack of water and not enough fibre in the diet. […] Constipation in babies needs special care. […] A healthy diet, having enough to drink, exercise, correct toilet training and regular toilet habits are important to prevent and help treat constipation in children. Treatment for infant constipation requires expert medical advice. […] Constipation is not just how often a child goes to the toilet. It also refers to how hard the stool (poo) is when it is passed. […] Constipation that goes on for a long time can cause other problems for children, such as soiling softer poo leaks out around a solid lump of poo and dirties underpants. […] The causes of a child’s constipation may not always be clear, but may include: If a child is drinking too much milk and not getting enough solids, the lack of fibre can cause constipation.

• #131 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Management of constipation includes dietary modifications, behavior interventions, medications, and disimpaction if needed. Treatment does not differ for preschool-aged children, older children, and adolescents. […] Quality of life scores are lower in children with chronic constipation than those without constipation. Children with functional constipation may experience shame, peer rejection, bullying, and recurrent treatment failures. Adolescents with functional constipation are at increased risk of depression, anxiety, somatic symptoms, withdrawal, and social problems. Current evidence does not support intensive behavior therapy or biofeedback in the treatment of functional constipation. However, minor behavior modifications such as structured toilet training with a reward system, in which the child is instructed to defecate after each meal, may prevent recurrence of fecal impaction.

• #132 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Management of constipation includes dietary modifications, behavior interventions, medications, and disimpaction if needed. Treatment does not differ for preschool-aged children, older children, and adolescents. […] Quality of life scores are lower in children with chronic constipation than those without constipation. Children with functional constipation may experience shame, peer rejection, bullying, and recurrent treatment failures. Adolescents with functional constipation are at increased risk of depression, anxiety, somatic symptoms, withdrawal, and social problems. Current evidence does not support intensive behavior therapy or biofeedback in the treatment of functional constipation. However, minor behavior modifications such as structured toilet training with a reward system, in which the child is instructed to defecate after each meal, may prevent recurrence of fecal impaction.

• #133 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Management of constipation includes dietary modifications, behavior interventions, medications, and disimpaction if needed. Treatment does not differ for preschool-aged children, older children, and adolescents. […] Quality of life scores are lower in children with chronic constipation than those without constipation. Children with functional constipation may experience shame, peer rejection, bullying, and recurrent treatment failures. Adolescents with functional constipation are at increased risk of depression, anxiety, somatic symptoms, withdrawal, and social problems. Current evidence does not support intensive behavior therapy or biofeedback in the treatment of functional constipation. However, minor behavior modifications such as structured toilet training with a reward system, in which the child is instructed to defecate after each meal, may prevent recurrence of fecal impaction.

• #134 Urology & Continence Care Today | May 2025

  https://www.ucc-today.com/journals/issue/launch-edition/article/early-recognition-and-proactive-management-constipation-children

  Functional constipation is a significant problem in childhood, not only due to its prevalence, but also the impact that it has on quality of life for the affected child and their families. […] Healthcare professionals need to raise awareness of this condition to facilitate prevention as well as early, appropriate intervention. […] Constipation is defined by the National Institute for Health and Care Excellence (NICE, 2014) as the inability to pass stools regularly or empty the bowels completely. […] Families presenting with concerns about their child’s bowel actions are often dismissed with minimum interventions, particularly at initial presentation. […] The consequences of chronic constipation are significant and pervasive, affecting many areas of the child and family’s life. […] Constipation is under-recognised by families and soiling is rarely identified as a symptom (NICE, 2010).

• #135 Constipation in Children: Symptoms, Treatment and Resources | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/constipation

  Children with soiling or more severe constipation usually require medication. […] Once your child is having soft, comfortable bowel movements on a regular basis, the next step is to get their regular toileting schedule back on track. […] Our team includes behavioral specialists who provide additional care for patients with encopresis. These specialists help your child: Get a regular toileting routine started, Have less anxiety around having a bowel movement, Reduce their stool withholding behavior, Have less conflict with their parents over the problem, Feel that they are part of the treatment team.

• #136 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  Constipation in children is a common problem. A constipated child has infrequent bowel movements or hard, dry stools. […] Encouraging your child to make simple dietary changes such as eating more fiber-rich fruits and vegetables and drinking more water can go a long way toward alleviating constipation. If your child’s doctor approves, it may be possible to treat a child’s constipation with laxatives. […] Constipation in children usually isn’t serious. However, chronic constipation may lead to complications or signal an underlying condition. Take your child to a doctor if the constipation lasts longer than two weeks or is accompanied by: Fever, Not eating, Blood in the stool, Abdominal swelling, Weight loss, Pain during bowel movements, Part of the intestine coming out of the anus (rectal prolapse).

• #137 Constipation: Home Care (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/constipation-sheet.html

  Constipation is a common problem in which a child may have fewer bowel movements (BMs or poops) than usual. It usually isn’t a cause for too much concern. […] Constipation can often get better with the three Fs: fluids, fiber, and fitness. […] Give your child plenty of water or juice. If your baby is constipated, ask the doctor about adding prune, apple, or pear juice to the daily diet. […] Increase the fiber in your child’s diet. Try apples, pears, oranges, beans, oatmeal, and whole-grain breakfast cereals or breads. […] Encourage daily exercise to help your child have regular bowel movements. […] Talk to your doctor before giving your child any medicine for constipation. […] Get Medical Care if Your Child Has: constipation lasting a week, liquid stool in the underwear when your child isn’t sick, severe belly pain, vomiting, eating less. […] Skip fatty, sugary, or starchy foods, which can slow the bowels down. Choose fiber-rich foods instead.

• #138 Constipation: Home Care (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/constipation-sheet.html

  Constipation is a common problem in which a child may have fewer bowel movements (BMs or poops) than usual. It usually isn’t a cause for too much concern. […] Constipation can often get better with the three Fs: fluids, fiber, and fitness. […] Give your child plenty of water or juice. If your baby is constipated, ask the doctor about adding prune, apple, or pear juice to the daily diet. […] Increase the fiber in your child’s diet. Try apples, pears, oranges, beans, oatmeal, and whole-grain breakfast cereals or breads. […] Encourage daily exercise to help your child have regular bowel movements. […] Talk to your doctor before giving your child any medicine for constipation. […] Get Medical Care if Your Child Has: constipation lasting a week, liquid stool in the underwear when your child isn’t sick, severe belly pain, vomiting, eating less. […] Skip fatty, sugary, or starchy foods, which can slow the bowels down. Choose fiber-rich foods instead.

• #139 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  Constipation in children is a common problem. A constipated child has infrequent bowel movements or hard, dry stools. […] Encouraging your child to make simple dietary changes such as eating more fiber-rich fruits and vegetables and drinking more water can go a long way toward alleviating constipation. If your child’s doctor approves, it may be possible to treat a child’s constipation with laxatives. […] Constipation in children usually isn’t serious. However, chronic constipation may lead to complications or signal an underlying condition. Take your child to a doctor if the constipation lasts longer than two weeks or is accompanied by: Fever, Not eating, Blood in the stool, Abdominal swelling, Weight loss, Pain during bowel movements, Part of the intestine coming out of the anus (rectal prolapse).

• #140 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  Constipation in children is a common problem. A constipated child has infrequent bowel movements or hard, dry stools. […] Encouraging your child to make simple dietary changes such as eating more fiber-rich fruits and vegetables and drinking more water can go a long way toward alleviating constipation. If your child’s doctor approves, it may be possible to treat a child’s constipation with laxatives. […] Constipation in children usually isn’t serious. However, chronic constipation may lead to complications or signal an underlying condition. Take your child to a doctor if the constipation lasts longer than two weeks or is accompanied by: Fever, Not eating, Blood in the stool, Abdominal swelling, Weight loss, Pain during bowel movements, Part of the intestine coming out of the anus (rectal prolapse).

• #141 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  Constipation in children is a common problem. A constipated child has infrequent bowel movements or hard, dry stools. […] Encouraging your child to make simple dietary changes such as eating more fiber-rich fruits and vegetables and drinking more water can go a long way toward alleviating constipation. If your child’s doctor approves, it may be possible to treat a child’s constipation with laxatives. […] Constipation in children usually isn’t serious. However, chronic constipation may lead to complications or signal an underlying condition. Take your child to a doctor if the constipation lasts longer than two weeks or is accompanied by: Fever, Not eating, Blood in the stool, Abdominal swelling, Weight loss, Pain during bowel movements, Part of the intestine coming out of the anus (rectal prolapse).

• #142 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  Constipation in children is a common problem. A constipated child has infrequent bowel movements or hard, dry stools. […] Encouraging your child to make simple dietary changes such as eating more fiber-rich fruits and vegetables and drinking more water can go a long way toward alleviating constipation. If your child’s doctor approves, it may be possible to treat a child’s constipation with laxatives. […] Constipation in children usually isn’t serious. However, chronic constipation may lead to complications or signal an underlying condition. Take your child to a doctor if the constipation lasts longer than two weeks or is accompanied by: Fever, Not eating, Blood in the stool, Abdominal swelling, Weight loss, Pain during bowel movements, Part of the intestine coming out of the anus (rectal prolapse).

• #143 Patient education: Constipation in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/constipation-in-infants-and-children-beyond-the-basics

  You can try using home remedies first to relieve your child’s constipation. These remedies should begin to work within 24 hours; if your child does not have a bowel movement with 24 hours or if you are worried, call your child’s doctor or nurse for advice. […] If your child has been constipated for a short time, changing what they eat may be the only treatment needed. You can make these changes as often as needed so that the child has soft and painless bowel movements. […] If your infant or child has repeated episodes of constipation (called recurrent constipation), work with your child’s doctor or nurse to figure out why this is happening. […] If your child develops constipation while learning to use the toilet, stop toilet training temporarily. It is reasonable to wait two to three months before restarting toilet training. […] Call your child’s doctor or nurse immediately (during the day or night) if your child has severe abdominal or rectal pain.

• #144 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  To help prevent constipation in children: Offer your child high-fiber foods. A diet rich in fiber can help your child’s body form soft, bulky stool. Serve your child more high-fiber foods, such as fruits, vegetables, beans, and whole-grain cereals and breads. […] Encourage your child to drink plenty of fluids. Water is often the best. […] Promote physical activity. Regular physical activity helps stimulate normal bowel function. […] Create a toilet routine. Regularly set aside time after meals for your child to use the toilet. […] Remind your child to heed nature’s call. Some children get so wrapped up in play that they ignore the urge to have a bowel movement. […] Be supportive. Reward your child’s efforts, not results. Give children small rewards for trying to move their bowels. […] Review medications. If your child is taking a medication that causes constipation, ask his or her doctor about other options.

• #145 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  To help prevent constipation in children: Offer your child high-fiber foods. A diet rich in fiber can help your child’s body form soft, bulky stool. Serve your child more high-fiber foods, such as fruits, vegetables, beans, and whole-grain cereals and breads. […] Encourage your child to drink plenty of fluids. Water is often the best. […] Promote physical activity. Regular physical activity helps stimulate normal bowel function. […] Create a toilet routine. Regularly set aside time after meals for your child to use the toilet. […] Remind your child to heed nature’s call. Some children get so wrapped up in play that they ignore the urge to have a bowel movement. […] Be supportive. Reward your child’s efforts, not results. Give children small rewards for trying to move their bowels. […] Review medications. If your child is taking a medication that causes constipation, ask his or her doctor about other options.

• #146 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  To help prevent constipation in children: Offer your child high-fiber foods. A diet rich in fiber can help your child’s body form soft, bulky stool. Serve your child more high-fiber foods, such as fruits, vegetables, beans, and whole-grain cereals and breads. […] Encourage your child to drink plenty of fluids. Water is often the best. […] Promote physical activity. Regular physical activity helps stimulate normal bowel function. […] Create a toilet routine. Regularly set aside time after meals for your child to use the toilet. […] Remind your child to heed nature’s call. Some children get so wrapped up in play that they ignore the urge to have a bowel movement. […] Be supportive. Reward your child’s efforts, not results. Give children small rewards for trying to move their bowels. […] Review medications. If your child is taking a medication that causes constipation, ask his or her doctor about other options.

• #147 Constipation

  https://www.rch.org.au/kidsinfo/fact_sheets/Constipation/

  You only need to worry about the firmness or frequency of your child’s poo if it seems to be causing a problem. In most cases, you can treat your child at home to help their constipation. […] Diet is less important in the treatment of constipation for children than it is for adults, but increasing fibre intake might help some children who have a natural tendency to be constipated. […] If your child is over the age of 18 months, reduce cow’s milk intake to a maximum of 500 ml per day and avoid sweet drinks before meals. This will help to improve your child’s appetite at meal times. […] For older children, if simple diet changes aren’t helping, your child is in significant pain or if they are bleeding from their bottom, you should take them to the GP. […] Constipation can usually be controlled with healthy bowel habits and medicines, as advised by a doctor.

• #148 Constipation: Home Care (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/constipation-sheet.html

  Constipation is a common problem in which a child may have fewer bowel movements (BMs or poops) than usual. It usually isn’t a cause for too much concern. […] Constipation can often get better with the three Fs: fluids, fiber, and fitness. […] Give your child plenty of water or juice. If your baby is constipated, ask the doctor about adding prune, apple, or pear juice to the daily diet. […] Increase the fiber in your child’s diet. Try apples, pears, oranges, beans, oatmeal, and whole-grain breakfast cereals or breads. […] Encourage daily exercise to help your child have regular bowel movements. […] Talk to your doctor before giving your child any medicine for constipation. […] Get Medical Care if Your Child Has: constipation lasting a week, liquid stool in the underwear when your child isn’t sick, severe belly pain, vomiting, eating less. […] Skip fatty, sugary, or starchy foods, which can slow the bowels down. Choose fiber-rich foods instead.

• #149 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  To help prevent constipation in children: Offer your child high-fiber foods. A diet rich in fiber can help your child’s body form soft, bulky stool. Serve your child more high-fiber foods, such as fruits, vegetables, beans, and whole-grain cereals and breads. […] Encourage your child to drink plenty of fluids. Water is often the best. […] Promote physical activity. Regular physical activity helps stimulate normal bowel function. […] Create a toilet routine. Regularly set aside time after meals for your child to use the toilet. […] Remind your child to heed nature’s call. Some children get so wrapped up in play that they ignore the urge to have a bowel movement. […] Be supportive. Reward your child’s efforts, not results. Give children small rewards for trying to move their bowels. […] Review medications. If your child is taking a medication that causes constipation, ask his or her doctor about other options.

• #150 Toddler Constipation: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17785-constipation-in-children

  If your toddler is constipated, you can often help them with home remedies. Home treatments for relief from constipation may include: Diet changes: Your child should eat plenty of fruits and vegetables to get extra fiber. Hydration: Give your toddler lots of water. Ask their healthcare provider about giving them fruit juices. Routine: Encourage your child to use the bathroom regularly, especially after eating. You may want to try a reward system. […] The following measures may help prevent constipation in your toddler: Diet: Make sure your child is getting enough fiber in their diet. This includes eating plenty of fruits and vegetables. Ask their healthcare provider about switching to lower-fat dairy products. Hydration: Encourage your child to drink plenty of water. Ask their healthcare provider about adding other liquids, including juice. Routine: Schedule a regular toilet routine. Physical activity: Get them moving with regular exercise and playtime. […] Take your child to their healthcare provider if their constipation lasts for more than two weeks and home remedies aren’t helping. Your child may need additional treatment.

• #151 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  To help prevent constipation in children: Offer your child high-fiber foods. A diet rich in fiber can help your child’s body form soft, bulky stool. Serve your child more high-fiber foods, such as fruits, vegetables, beans, and whole-grain cereals and breads. […] Encourage your child to drink plenty of fluids. Water is often the best. […] Promote physical activity. Regular physical activity helps stimulate normal bowel function. […] Create a toilet routine. Regularly set aside time after meals for your child to use the toilet. […] Remind your child to heed nature’s call. Some children get so wrapped up in play that they ignore the urge to have a bowel movement. […] Be supportive. Reward your child’s efforts, not results. Give children small rewards for trying to move their bowels. […] Review medications. If your child is taking a medication that causes constipation, ask his or her doctor about other options.

• #152 Nursing Care Plan (NCP) for Constipation / Encopresis | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-constipation-encopresis

  Dietary changes help the colon process stool and help make the stool more easy to pass. […] Activity and exercise help promote peristalsis and the passage of stool. […] Routines are important for children, so setting times for bowel movements can help eliminate the need to withhold stool. […] Children need to have plenty of time, especially if passing hard stools. Rushing can cause them to withhold and make constipation worse.

• #153

  https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/constipation.aspx

  It is important to note that fiber supplements taken without enough water can worsen your child’s constipation! […] Children sometimes have bad posture on the toilet: they slump at the waist and do not sit up straight, they cross their legs, their legs dangle in the air or they clinch their bottom cheeks together. […] One tool to improve toilet posture is the defecation posture modification device, a potty stool. This kind of stool can improve toileting posture by promoting the relaxation of the puborectalis muscle and straightening of the „ano-rectal” angle to make passing a poop easier. […] There are many laxative medicines available to treat children with functional constipation including stool softeners, osmotic laxatives, stimulant laxatives, secretagogue laxatives and rectal therapies.

• #154 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  To help prevent constipation in children: Offer your child high-fiber foods. A diet rich in fiber can help your child’s body form soft, bulky stool. Serve your child more high-fiber foods, such as fruits, vegetables, beans, and whole-grain cereals and breads. […] Encourage your child to drink plenty of fluids. Water is often the best. […] Promote physical activity. Regular physical activity helps stimulate normal bowel function. […] Create a toilet routine. Regularly set aside time after meals for your child to use the toilet. […] Remind your child to heed nature’s call. Some children get so wrapped up in play that they ignore the urge to have a bowel movement. […] Be supportive. Reward your child’s efforts, not results. Give children small rewards for trying to move their bowels. […] Review medications. If your child is taking a medication that causes constipation, ask his or her doctor about other options.

• #155 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  To help prevent constipation in children: Offer your child high-fiber foods. A diet rich in fiber can help your child’s body form soft, bulky stool. Serve your child more high-fiber foods, such as fruits, vegetables, beans, and whole-grain cereals and breads. […] Encourage your child to drink plenty of fluids. Water is often the best. […] Promote physical activity. Regular physical activity helps stimulate normal bowel function. […] Create a toilet routine. Regularly set aside time after meals for your child to use the toilet. […] Remind your child to heed nature’s call. Some children get so wrapped up in play that they ignore the urge to have a bowel movement. […] Be supportive. Reward your child’s efforts, not results. Give children small rewards for trying to move their bowels. […] Review medications. If your child is taking a medication that causes constipation, ask his or her doctor about other options.

• #156 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  To help prevent constipation in children: Offer your child high-fiber foods. A diet rich in fiber can help your child’s body form soft, bulky stool. Serve your child more high-fiber foods, such as fruits, vegetables, beans, and whole-grain cereals and breads. […] Encourage your child to drink plenty of fluids. Water is often the best. […] Promote physical activity. Regular physical activity helps stimulate normal bowel function. […] Create a toilet routine. Regularly set aside time after meals for your child to use the toilet. […] Remind your child to heed nature’s call. Some children get so wrapped up in play that they ignore the urge to have a bowel movement. […] Be supportive. Reward your child’s efforts, not results. Give children small rewards for trying to move their bowels. […] Review medications. If your child is taking a medication that causes constipation, ask his or her doctor about other options.

• #157 Patient education: Constipation in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/constipation-in-infants-and-children-beyond-the-basics

  You can try using home remedies first to relieve your child’s constipation. These remedies should begin to work within 24 hours; if your child does not have a bowel movement with 24 hours or if you are worried, call your child’s doctor or nurse for advice. […] If your child has been constipated for a short time, changing what they eat may be the only treatment needed. You can make these changes as often as needed so that the child has soft and painless bowel movements. […] If your infant or child has repeated episodes of constipation (called recurrent constipation), work with your child’s doctor or nurse to figure out why this is happening. […] If your child develops constipation while learning to use the toilet, stop toilet training temporarily. It is reasonable to wait two to three months before restarting toilet training. […] Call your child’s doctor or nurse immediately (during the day or night) if your child has severe abdominal or rectal pain.

• #158 Constipation in Children: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.constipation-in-children-care-instructions.ut1883

  Constipation is difficulty passing hard stools and passing fewer stools. How often your child has a bowel movement is not as important as whether the child can pass stools easily. Constipation has many causes in children. These include medicines, changes in diet, not drinking enough fluids, and changes in routine. […] You can prevent constipation or treat it when it happens with home care. But some children may have ongoing constipation. It can occur when a child does not eat enough fiber. Or toilet training may make a child want to hold in stools. Children at play may not want to take time to go to the bathroom. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It’s also a good idea to know your child’s test results and keep a list of the medicines your child takes.

• #159 Constipation in Children: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.constipation-in-children-care-instructions.ut1883

  For children 1 year or older, give your child plenty of water and other fluids. Include high-fiber foods like fruits, vegetables, beans, or whole grains in your child’s diet each day. Have your child take medicines exactly as prescribed. Call your doctor if you think your child is having a problem with a medicine. Make sure your child gets daily exercise. It helps the body have regular bowel movements. Tell your child to go to the bathroom when they have the urge. Do not give laxatives or enemas to your child unless your child’s doctor recommends it. Make a routine of putting your child on the toilet or potty chair after the same meal each day. […] Call your doctor now or seek immediate medical care if there is blood in your child’s stool, your child has severe belly pain, or your child is vomiting. Watch closely for changes in your child’s health, and be sure to contact your doctor if your child’s constipation gets worse.

• #160 Constipation and children | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation-and-children

  Some children ignore the urge to go to the toilet because they are too busy playing. […] Some children hold back when they are being toilet trained. […] Some children dont want to use school or preschool toilets for various reasons, such as lack of privacy or a smelly toilet. […] The child may not be getting enough exercise. […] Some of the signs of constipation in children include: saying that it hurts when doing a poo, showing signs of holding on such as crossing legs, running around, crying or refusing to sit on the toilet, complaining of tummy pain, soiling their pants (with ongoing constipation). […] Suggestions for treating constipation in children include: Encourage your child to exercise more. […] Establish a regular toilet routine. […] Limit the use of laxatives. […] Try to solve the problem quickly the longer your child remains constipated, the worse it may become and the longer it may take to treat.

• #161 Pediatric Functional Constipation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537037/

  Healthcare professionals can educate parents and caregivers on recognizing signs, promoting a fiber-rich diet, and establishing healthy toilet habits during toilet training. […] A holistic, patient-centered approach, incorporating preventive measures and collaborative care, contributes to improved outcomes and enhances the overall quality of life for children affected by this common gastrointestinal condition.

• #162 Urology & Continence Care Today | May 2025

  https://www.ucc-today.com/journals/issue/launch-edition/article/early-recognition-and-proactive-management-constipation-children

  In typically developing children, soiling is often thought to be the result of behavioural issues, such as psychological problems, toilet avoidance, laziness or naughtiness, and too frequently parents will only ask for healthcare support when they can no longer cope with the washing or social impact of soiling, by which stage the problem has become chronic. […] Up to 90-95% of childhood constipation is functional or idiopathic (Tabbers et al, 2014; Madani et al, 2016; Collis et al, 2019). […] The aim for all children should be: Prevention, Early identification, Effective treatment. […] If information about the signs and symptoms of constipation were included in all parent-held child health records and discussed at all routine contacts by health visitors and school nurses, there would be less stigma and embarrassment, and families would recognise the problem earlier and know how and when to seek help.

• #163 Pediatric Functional Constipation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537037/

  Healthcare professionals can educate parents and caregivers on recognizing signs, promoting a fiber-rich diet, and establishing healthy toilet habits during toilet training. […] A holistic, patient-centered approach, incorporating preventive measures and collaborative care, contributes to improved outcomes and enhances the overall quality of life for children affected by this common gastrointestinal condition.

• #164 Constipation in children – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242

  To help prevent constipation in children: Offer your child high-fiber foods. A diet rich in fiber can help your child’s body form soft, bulky stool. Serve your child more high-fiber foods, such as fruits, vegetables, beans, and whole-grain cereals and breads. […] Encourage your child to drink plenty of fluids. Water is often the best. […] Promote physical activity. Regular physical activity helps stimulate normal bowel function. […] Create a toilet routine. Regularly set aside time after meals for your child to use the toilet. […] Remind your child to heed nature’s call. Some children get so wrapped up in play that they ignore the urge to have a bowel movement. […] Be supportive. Reward your child’s efforts, not results. Give children small rewards for trying to move their bowels. […] Review medications. If your child is taking a medication that causes constipation, ask his or her doctor about other options.

• #165 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. Polyethylene glycol is the first-line treatment for constipation. Second-line options include lactulose and enemas. Increasing dietary fiber and fluid intake above usual daily recommendations and adding probiotics provide no additional benefits for treating constipation. Frequent follow-up visits and referrals to a psychologist can assist in reaching some treatment goals. Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers’ specific challenges and the negative effects of constipation on the child’s quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #166 Constipation in children and young people: diagnosis and management – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554924/

  Constipation is common in childhood. It is prevalent in around 530% of the child population, depending on the criteria used for diagnosis. Symptoms become chronic in more than one third of patients and constipation is a common reason for referral to secondary care. […] Painful defecation is an important factor in constipation but it is not always recognised; withholding behaviours to prevent passage of painful stools are often confused with straining to pass stools. Families may delay seeking help for fear of a negative response from healthcare professionals. […] Without early diagnosis and treatment, an acute episode of constipation can lead to anal fissure and become chronic. By the time the child or young person is seen they may be in a vicious cycle. […] Early identification of constipation and effective treatment can improve outcomes for children and young people. This guideline provides strategies based on the best available evidence to support early identification, positive diagnosis and timely, effective management.

• #167 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children is usually functional constipation without an organic cause. Organic causes of constipation in children, which include Hirschsprung disease, cystic fibrosis, and spinal cord abnormalities, commonly present with red flag signs and symptoms. A history and physical examination can diagnose functional constipation using the Rome IV diagnostic criteria. The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. Polyethylene glycol is the first-line treatment for constipation. Second-line options include lactulose and enemas. Increasing dietary fiber and fluid intake above usual daily recommendations and adding probiotics provide no additional benefits for treating constipation. Frequent follow-up visits and referrals to a psychologist can assist in reaching some treatment goals. Clinicians should educate caregivers about the chronic course of functional constipation, frequent relapses, and the potential for prolonged therapy. Clinicians should acknowledge caregivers’ specific challenges and the negative effects of constipation on the child’s quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #168 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation. Fecal impaction can be diagnosed by a history of overflow soiling, the presence of a palpable fecal mass during an abdominal examination, or hard stool in a dilated rectum if a digital rectal examination is warranted. Disimpaction can be achieved by using oral or rectal medications. Polyethylene glycol (Miralax) is a polymer that is minimally absorbed by the gastrointestinal tract, leading to water retention in the intestine and softened stools. Polyethylene glycol is the first-line treatment because it is more effective than other agents for disimpaction and maintenance therapy, is well-tolerated, and has a low risk of adverse effects. […] Maintenance therapy should be started in children without impaction or when disimpaction is achieved. The goals of maintenance therapy are to achieve soft stool daily or every other day and to prevent stool impaction. Polyethylene glycol is superior to other oral laxatives and is recommended as a first-line maintenance treatment for constipation. The starting maintenance dosage of polyethylene glycol is 0.4 g per kg per day, and caregivers should be advised that it can be increased or decreased to maintain soft stool every day or every other day without diarrhea. Polyethylene glycol appears to be safe for long-term use in children.

• #169 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation. Fecal impaction can be diagnosed by a history of overflow soiling, the presence of a palpable fecal mass during an abdominal examination, or hard stool in a dilated rectum if a digital rectal examination is warranted. Disimpaction can be achieved by using oral or rectal medications. Polyethylene glycol (Miralax) is a polymer that is minimally absorbed by the gastrointestinal tract, leading to water retention in the intestine and softened stools. Polyethylene glycol is the first-line treatment because it is more effective than other agents for disimpaction and maintenance therapy, is well-tolerated, and has a low risk of adverse effects. […] Maintenance therapy should be started in children without impaction or when disimpaction is achieved. The goals of maintenance therapy are to achieve soft stool daily or every other day and to prevent stool impaction. Polyethylene glycol is superior to other oral laxatives and is recommended as a first-line maintenance treatment for constipation. The starting maintenance dosage of polyethylene glycol is 0.4 g per kg per day, and caregivers should be advised that it can be increased or decreased to maintain soft stool every day or every other day without diarrhea. Polyethylene glycol appears to be safe for long-term use in children.

• #170 Managing idiopathic constipation in children | Nursing Times

  https://www.nursingtimes.net/archive/managing-idiopathic-constipation-in-children-28-03-2011/

  Nurses are well-placed to offer advice and support to those involved with the care of children with constipation. […] Constipation affects up to one in three children in the UK. […] It is important to recognise and treat constipation early to avoid debilitating long-term physical and psychological consequences, as well as educational disadvantages to the child. Nurses are well-placed to offer advice and support, to liaise with teachers and other relevant healthcare professionals, and to make decisions appropriate to individual circumstances in consultation with children and their parents or guardians. […] The aim is to clear faecal impaction, establish a regular bowel pattern and to prevent recurrence. […] It is essential to spend time at the initial consultation to explain that constipation is common and likely to improve with age and simple therapies such as behavioural modification and laxatives, and that while treatment is usually successful it may take several months with prolonged courses of laxatives.

• #171 Constipation in Children and Adolescents: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0500/p469.html

  Constipation in children and adolescents is defined as passing delayed or infrequent hard stools with pain and excessive straining. The prevalence of constipation in children and adolescents is estimated to be as high as 30% worldwide. Constipation in children accounts for 3% of primary care physician visits and up to 25% of referrals to pediatric gastroenterologists. Children with constipation incur three times the health care costs of children without constipation, and chronic constipation can have a negative effect on the child’s quality of life. […] Functional constipation is diagnosed by history and physical examination findings in patients without red flag signs or symptoms. Digital rectal examination and abdominal radiography should not be performed routinely in children with suspected functional constipation. Increasing fiber or fluid intake above usual daily recommendations does not improve constipation in children. Probiotics are not beneficial in the treatment of constipation in children. Referring children with functional constipation to a child psychologist can improve some constipation outcomes. Polyethylene glycol (Miralax) is first-line treatment for functional constipation in children.

• #172 Evaluation and Treatment of Constipation in Children and Adolescents | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0715/p82.html

  The addition of laxatives is more effective than behavior modification alone in children with constipation. […] Most children with functional constipation require prolonged treatment. […] The treatment of functional constipation requires parental education, behavior interventions, measures to ensure that bowel movements occur at normal intervals with good evacuation, close follow-up, and adjustment of medication and evaluation as necessary. […] Education is the first step in treatment. […] Dietary changes are often advised in children with constipation. […] When fecal impaction is present, disimpaction with oral or rectal medication is required before initiation of maintenance therapy. […] The goal of maintenance therapy is to avoid reaccumulation of stool by maintaining soft bowel movements, preferably occurring once a day. […] Most children with functional constipation require prolonged treatment and have frequent relapses. […] Referral to a pediatric gastroenterologist may be needed when a child with constipation has red flags for organic disease or the constipation is unresponsive to adequate therapy.

• #173 Urology & Continence Care Today | May 2025

  https://www.ucc-today.com/journals/issue/launch-edition/article/early-recognition-and-proactive-management-constipation-children

  Functional constipation is a significant problem in childhood, not only due to its prevalence, but also the impact that it has on quality of life for the affected child and their families. […] Healthcare professionals need to raise awareness of this condition to facilitate prevention as well as early, appropriate intervention. […] Constipation is defined by the National Institute for Health and Care Excellence (NICE, 2014) as the inability to pass stools regularly or empty the bowels completely. […] Families presenting with concerns about their child’s bowel actions are often dismissed with minimum interventions, particularly at initial presentation. […] The consequences of chronic constipation are significant and pervasive, affecting many areas of the child and family’s life. […] Constipation is under-recognised by families and soiling is rarely identified as a symptom (NICE, 2010).

• #174 Pediatric Functional Constipation | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/21993

  Normal fiber and fluid intake are recommended for children with constipation, along with an average amount of physical activity. […] Deterrence and patient education play pivotal roles in addressing pediatric functional constipation. […] Identifying pediatric functional constipation requires a thorough understanding of common symptoms such as infrequent, painful bowel movements and hard stools. […] The disposition in pediatric functional constipation involves a multidisciplinary approach. […] Successful treatment of functional constipation requires an interprofessional team approach.

Zobacz więcej