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. […] The first goal of managing constipation is to treat fecal impaction, and then maintenance therapy is used to prevent a recurrence. […] 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. […] Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.

• #1 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 OVERVIEW […] 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. […] This article will focus on the diagnosis, treatment, and prevention of constipation. […] CONSTIPATION AND DEVELOPMENT […] 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.

• #1 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. […] Prompt recognition and intervention with appropriate laxative therapy, alongside adjustment to diet, fluids and toileting, if required, will prevent the condition becoming chronic. […] Healthcare professionals need to raise awareness of this condition to facilitate prevention as well as early, appropriate intervention. […] 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. Crucially, prompt proactive treatment with laxatives would reduce the incidence of the condition becoming chronic.

• #1 NHS England » National clinical constipation pathway for primary care for children

  https://www.england.nhs.uk/long-read/national-clinical-constipation-pathway-for-primary-care-for-children/

  This guidance supports clinicians in the prevention and management of constipation in children and young people with the following actions: […] Laxatives are always first line management of acute or chronic constipation in children. The aim is to titrate doses to ensure the passage of soft, pain free stools and to overcome any withholding behaviours. […] Do not use diet and fluids alone as treatment. Diet and fluid adjustments do not break down hard faeces and there is evidence that constipation is unrelated to diet and fluid intake in about 59% of affected children. […] When constipation has persisted for more than four weeks it is considered chronic. Resolution can take six months or more if the child has developed mega-rectum or mega-colon. Maintenance doses of laxatives for chronic constipation should be continued for at least three to six months after symptoms resolve and toilet training is established unless loose stools develop.

• #1 Constipation in Children: Symptoms, Causes, and Treatment

  https://patient.info/digestive-health/constipation/constipation-in-children

  Constipation is a very common problem for children. […] It is important that constipation be recognised early to prevent it from becoming a long-term (chronic) problem. […] You can help prevent constipation in your child by making sure they are eating foods with plenty of fibre and drinking plenty. This makes stools (faeces) that are bulky soft and easy to pass out. Getting plenty of exercise is also thought to help. […] Dietary measures should not be used on their own to treat idiopathic constipation, as it will be unlikely to solve the problem. However, it is still important to get a child into a habit of eating a good balanced diet. This is to include plenty of drinks (mainly water) and foods with fibre. This will help to prevent a recurrence of constipation once it has cleared. […] The Association of UK Dietitians recommends normal daily fibre intake (from the age of 2 years) should be as follows: Age 2-5: 15 g fibre per day. Age 6-11: 20 g fibre per day. Age 12-15: 25 g fibre per day. Age 16+: 30 g fibre per day.

• #1 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. […] Mild constipation may be treated with dietary changes. Increased fiber in the diet along with normal water or fluid intake may soften the stools. […] Children with soiling or more severe constipation usually require medication. However, making changes in your child’s diet at the same time may help wean them from medications more quickly. […] The correct amount of fiber is equivalent to your child’s age plus 5 grams.

• #1 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. […] 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.

• #1 Resolving Toddler Constipation: Do’s and Don’ts | Henry Ford Health – Detroit, MI

  https://www.henryford.com/blog/2016/11/toddler-constipation

  Let your child load up on constipating foods. Sugar and refined carbohydrates (like white bread, pasta and rice) are known toddler constipation culprits. Bananas and dairy, too, may lead to toilet troubles. […] A stool softener or laxative may be the answer to toddler constipation, but these should never be given to a child without a doctor’s recommendation. Once your child has regular, soft, formed stools, she’ll gain the confidence that she can have a bowel movement without pain.

• #1 Constipation in children: treatment | gesund.bund.de

  https://gesund.bund.de/en/constipation-in-children

  Constipation in children is particularly common among those of preschool age. Stool softeners, toilet training and dietary changes are the key elements of a successful treatment plan. […] For those who may be more susceptible to becoming constipated, the recommendations for prevention largely concern diet. […] The following recommendations apply to children aged between 0 and 2 years old: Up to the age of 6 months, feed with breast milk only. In older babies, breast milk continues to be recommended as it promotes healthy digestion. From the age of 6 months, slowly introduce increasing amounts of solids into the diet. Feed regularly based on when the child is hungry. If the child becomes ill, respond with flexibility to changes in their intake. Offer as varied a diet as possible, with a variety of fruit and vegetables. Avoid sugar, soft drinks, salty snacks and processed or deep-fried foods. […] To promote digestion in school-aged children, ensure that they drink at least three glasses of water a day and eat plenty of fruit and vegetables.

• #1 Constipation in Children: Symptoms, Causes, and Treatment

  https://patient.info/digestive-health/constipation/constipation-in-children

  If a bottle-fed baby has a tendency to become constipated, you can try offering water between feeds. […] Encourage children to drink plenty. However, some children get into the habit of only drinking squash, fizzy drinks or milk to quench their thirst. […] Try to get children into a regular toilet habit. After breakfast, before school or nursery, is often best. […] Toilet training should be relaxed. […] Encouraging your child is helpful. Some kind of reward system is sometimes useful in younger children prone to holding on to stools. […] Try to keep calm and not make a fuss over the toilet issue.

• #1 Coping With Constipation | Children’s Hospital of Philadelphia

  https://www.chop.edu/news/coping-constipation

  Constipation happens to all of us at some time or another. And it can be a frustrating and painful experience for kids and their caretakers. […] You can usually treat constipation at home with high-fiber foods and lots of fluids. Do not use any suppositories, laxatives or enemas without first consulting your childs doctor or nurse practitioner. […] For children younger than 4 months old, Dr. Kapavarapu suggests this mixture: 1 ounce of prune juice, apple or pear in 1 ounce of water, one or two times a day. […] For children 4 months to 1 year: High-fiber baby foods, such as cereals (mulitgran, barely, oatmeal), fruits (especially prunes), vegetables, spinach and peas. Fruits like prune, pear or apple and if needed the juice forms of these fruits are helpful. […] For children 1 year or older: Feed them raw, unpeeled vegetables and fruits (peaches, apples and pears) at least three times a day. Increase the bran in their diet with graham crackers, bran cereal, oatmeal and whole-wheat bread. Decrease the amount of dairy products you give them. Increase their water and juice intake. Have your child sit on the child on the toilet for 10 minutes after meals, especially after breakfast or dinner, to encourage a regular bowel pattern.

• #1

  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. […] Read on for more information about constipation (signs and symptoms, causes and treatment) and how to help your child develop good bowel habits. […] 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. When the body does not get enough water, it becomes dehydrated and takes water from the gut and pushes it to other important places in the body, like the heart. This can be what starts the cycle to make poops harder. Increasing a child’s water intake without medicines is not an effective treatment for constipation.

• #1 Constipation in Kids: Causes & Treatment | Lurie Children’s

  https://www.luriechildrens.org/en/blog/constipation-in-kids/

  Difficult or irregular bowel movements are very common during childhood. Luckily, most cases of constipation in kids are temporary and there are many diet and lifestyle changes that can help alleviate symptoms. […] A diet full of fresh fruits and vegetables and high-fiber foods helps support healthy bowel movements. […] Here are the daily fluid recommendations (per GI Kids, note: 1 cup = 8 ounces) for children: 1-3 years old: 45-50 ounces a day, 4-8 years old: 55-60 ounces a day, 9-13 years old: 80-85 ounces a day for males, 70-75 ounces a day for females, 14 years old and older: 100-110 ounces a day for males, 75-80 ounces a day for females. […] Many people do not poop every day but stooling two times per week or less in toddlers and older children is considered abnormal. […] For those with toilet aversion, doing pleasurable activities (reading, listening to music, etc.) is acceptable to help overcome the fear of sitting on the toilet. Make sure that the child’s stools are soft (either by diet or laxatives), so that they learn that stooling isn’t painful. […] Depending on your child’s age, over-the-counter laxatives, like polyethylene glycol (Miralax) and senna or sennosides (ExLax), are very safe. […] Long-term constipation may lead to soiling or encopresis, stool impaction and abdominal pain.

• #1

  https://www.eirmc.com/healthy-living/blog/constipated-kids-prevention-tips-and-when-to-see-a-doctor

  Constipation is a common problem among children of all ages. […] If you think that your child might be constipated, follow our prevention tips and find out when to see a doctor. […] For kids aged one through 18, here are some ways to help prevent constipation: […] Ensure proper fluid intake […] Kids aged 8 and up should drink about 64 ounces of fluids daily. […] Ensure proper fiber intake […] Good sources of fiber include whole grains, non-starchy vegetables, whole fruits, beans, legumes, nuts and seeds. […] Ensure proper potty posture […] Be aware that some children dont want to interrupt their playtime to have a bowel movement, so be sure kids spend enough time on the toilet. […] Encourage daily physical activity […] According to the CDC, children aged 3 through 5 need to be active throughout the day; children and adolescents aged 6 through 17 need to be active for 60 minutes every day. […] If your child has symptoms that last more than two weeks or have not been resolved by the diet and exercise recommendations above, you should make an appointment with your pediatrician.

• #1 Constipation in Kids: Causes and Treatment – Children’s Health

  https://www.childrens.com/health-wellness/constipation-in-kids

  Stay physically active: One of my colleagues says theres no such thing as a constipated runner, Dr. Sanghavi says. Make sure your child gets 30 to 45 minutes of moderate exercise throughout the day. […] If you have applied the three pillars and your child is still constipated, you should see a pediatrician. The first line of treatment is usually mild laxatives and further modification of diet, says Dr. Sanghavi. […] Although some parents might be concerned about the use of laxatives in children due to recent publicity about MiraLAX, Dr. Sanghavi says laxatives are generally safe and effective for treating constipation in kids.

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

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

  Encouraging healthy toilet habits – If your child is toilet trained, encourage them to sit on the toilet for approximately 10 minutes once or twice a day after eating. The child is more likely to have a bowel movement after a meal, especially breakfast. […] BEHAVIOR CHANGES […] In children who have constipation frequently, behavior changes are recommended to help the child develop normal bowel habits. […] – Encourage your child to sit on the toilet within 30 minutes after each meal (ie, for 10 minutes two to three times per day). Do this every day if possible. […] – Design a reward system with your child to recognize the child’s efforts. Give the reward after the child sits, even if they do not have a bowel movement. […] – Keep a diary of your child’s bowel movements, medicines, pain, and accidents. This will help you and your child’s doctor or nurse figure out if there are triggers for constipation.

• #1 Pediatric Constipation Treatment & Management: Approach Considerations, Colon Evacuation, Removal of Pain-Associated Defecation

  https://emedicine.medscape.com/article/928185-treatment

  Although constipation is an extremely common problem among children, few studies have systematically evaluated different management strategies. Childhood constipation is treated in many ways, and virtually any therapeutic regimen is likely to be effective as long as it is sufficiently aggressive and persistent. Because of the medical profession’s understanding of the pathophysiology of the problem, the basic tenets of therapy include evacuation of the colon, elimination of pain with defecation, and establishing regular bowel habits. […] In many cases, long-term success in the management of constipation depends on the child establishing regular and routine toilet times. It is generally recommended that the child be encouraged to attend the toilet twice daily for 5-10 minutes, preferably after breakfast and after supper to take advantage of the gastrocolic reflex.

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

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

  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.

• #1 Constipation in children – NHS

  https://www.nhs.uk/baby/health/constipation-in-children/

  Make sure your child can rest their feet flat on the floor or a step when they’re using the potty or toilet, to get them in a good position for pooing. […] Ask if they feel worried about using the potty or toilet some children do not want to poo in certain situations, such as at nursery or school. […] Stay calm and reassuring, so that your child does not see going to the toilet as a stressful situation you want your child to see pooing as a normal part of life, not something to be ashamed of.

• #1

  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. A recent study showed that the potty stool is safe and effective (when used with medicines) to treat functional constipation in toilet-trained children. […] There is research showing that children and parents benefit from receiving a Constipation Action Plan at the time of diagnosis. These plans help parents understand what amounts (doses) of medicines to give at what times, and, if need be, to give larger doses in response to worsening symptoms.

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

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

  Dietary recommendations […] – Fruit juice – Certain fruit juices can help to soften bowel movements. These include prune, apple, or pear (other juices are not as helpful). […] – Fluids – It is not necessary to drink large amounts of fluid to treat constipation, although it is reasonable to be sure that the child drinks enough fluid. […] – Food recommendations – Offer your child a well-balanced diet, including whole-grain foods, fruits, and vegetables. […] A fiber supplement may be recommended for some children. Fiber supplements are available in several forms, including wafers, chewable tablets, or powdered fiber that can be mixed in juice (or frozen into popsicles). […] Approach to toilet training – 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. When you resume, encourage your child to sit on the toilet or potty as soon as they feel the urge to have a bowel movement and give positive reinforcement (a hug, kiss, or words of encouragement) for trying, whether or not the child is successful.

• #1 Paediatric constipation: An approach and evidence-based treatment regimen

  https://www1.racgp.org.au/ajgp/2018/may/paediatric-constipation

  Constipation affects 530% of children and is responsible for 3% of primary care visits. […] It is important to initiate a clear management plan for the family, as what is an easily treatable condition can escalate into a vicious cycle of pain if not addressed early. The medical approach should consider organic disease, the use of appropriate toileting habits, and dietary modifications. Laxatives are often required to re-establish regular, painless defaecation. […] Normal fibre intake, fluid intake and exercise are recommended for children with constipation. Fibre supplements are not recommended. […] For children who are not yet toilet-trained for stool, and who feel more secure defaecating in a diaper, this should be encouraged while the stool is softened with laxatives and the child regains confidence. Toilet training should be child-led. Routine is important; if old enough to comply, children should be encouraged to sit on the toilet for five minutes after every meal. This can be used in conjunction with a rewards program such as a star chart.

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

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

  Quality of life scores are lower in children with chronic constipation than those without constipation. […] 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. […] Some studies have shown that combining medical and behavior therapy can improve fecal incontinence and other clinical outcomes. […] Clinicians should acknowledge the possible negative effects of functional constipation on the child’s parents or caregivers. […] For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation.

• #1

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

  Constipation is common and it affects children of all ages. […] 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. […] Encourage your child to be active. This will help to treat the constipation. It is also important for your child’s general health, growth and development. […] You might find it useful to encourage your child into a regular bowel pattern. You can do this by using 'bowel training’. […] Some parents find star charts helpful.

• #1 Constipation: A Parent’s Guide to Prevention and Treatment

  https://news.childrensmercy.org/constipation-a-parents-guide-to-prevention-and-treatment/

  Positive reinforcement and rewards can be very helpful with bowel training. Offer kids a small reward or treat such as a piece of candy or electronic time immediately after completing a toilet sit. […] Constipation is definitely fixable but it takes a commitment from both patients and parents. Often kids are taking medication daily for many months or longer to keep stools soft and regular.

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

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

  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. […] Management of constipation includes dietary modifications, behavior interventions, medications, and disimpaction if needed. […] Dietary interventions should be used only as first-line treatment for constipation in infants. […] Although low fluid and fiber intake may contribute to the development of constipation, increasing fluid (water, milk, other beverages) or fiber intake above usual daily recommendations does not improve constipation in children.

• #1 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. […] 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. […] Education is as important as medical therapy in successfully managing functional constipation. […] Recognize withholding behaviors and use behavioral interventions: Regular toileting. Tell parents that the child is to sit on toilet 2 to 3 times daily, 5 to 10 minutes each, for protected time to have a BM. Ensure that smaller children have a step stool so feet touch solid surface. […] Recommend normal fiber and fluid intake for age. Addition of prebiotics and probiotics to the regimen is not currently supported by adequate evidence. […] Emphasize if families are having difficulties, they should follow up to discuss referral to a pediatric gastroenterologist.

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

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

  Disimpaction can be achieved by using oral or rectal medications. […] 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. […] Maintenance therapy should be continued for at least two months or at least one month after a good response to treatment. […] Relapses are common and should be treated with maintenance therapy or disimpaction therapy when appropriate. […] After constipation is diagnosed and the treatment plan is determined, frequent follow-up is recommended to ensure that disimpaction has been achieved and that maintenance therapy is effective. […] Clinicians should educate caregivers about functional constipation’s chronic course and frequent relapses, and the possible need for prolonged therapy.

• #1 Pediatric Constipation: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/928185-overview

  Constipation in children has reported prevalence rates between 1% and 30%. It is the principal complaint in 3-5% of all visits to pediatric outpatient clinics and as many as 35% of all visits to pediatric gastroenterologists. […] For practical clinical purposes, constipation is generally defined as infrequent defecation, painful defecation, or both. In most cases, parents are worried that their child’s stools are too large, too hard, not frequent enough, and/or painful to pass. […] It is very important to educate the family that using laxatives continuously for months may be necessary. This is particularly true in toddlers, because many months may pass before their association between the fear of pain and defecation is extinguished. […] Caregivers should be reassured as to the safety of long-term laxative use, and the importance of persistent treatment should be strongly reinforced. Address the common misconceptions about laxative dependency and the increased risk of colon cancer due to long-term laxative usage. […] Inform the family that relapses are common and are often associated with changes in the child’s daily routine (eg, vacations) or during times of stress. Also, inform the family that the requirement of intermittent therapy with laxatives into adulthood is not unusual.

• #1 NHS England » National clinical constipation pathway for primary care for children

  https://www.england.nhs.uk/long-read/national-clinical-constipation-pathway-for-primary-care-for-children/

  Children with disabilities are more prone to constipation than their typically developing peers. It must be treated proactively to prevent long-term morbidities and potential mortality in the young person or young adult with a learning disability. […] Continued provision of prescriptions for laxatives is essential to allow the bowel to recover and prevent withholding due to fear of painful bowel actions. […] Acute constipation (history of less than four weeks) often needs proactive ongoing, preventative treatment so that it does not become chronic due to pain on bowel opening resulting in fear and withholding. […] Regular follow up improves outcomes. Family should be contacted one week after commencing disimpaction, two weeks after commencing maintenance, then within a further four weeks and then within eight weeks. Further follow up should continue as appropriate to the child and family. […] Reassess as appropriate to the child and family. If no improvement after three months refer to specialist service (local childrens bladder and bowel service if there is one or to a paediatrician).

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

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

  If your child does not have a bowel movement within 24 hours of trying the following suggestions, call your child’s doctor or nurse. […] Dietary recommendations […] Offer your child a well-balanced diet, including whole-grain foods, fruits, and vegetables. […] If your child develops constipation while learning to use the toilet, stop toilet training temporarily. […] Encourage your child to sit on the toilet for approximately 10 minutes once or twice a day after eating. […] If your child has been constipated for a short time, changing what they eat may be the only treatment needed. […] If your child is constipated, follow the dietary guidelines above. Also, encourage your child to drink at least 4 to 8 cups (32 to 64 ounces) of fluid per day, preferably water, low-fat milk, and low-sugar decaffeinated beverages.

• #1 Constipation

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

  You should consult your GP or Maternal and Child Health Nurse. […] See your doctor if simple diet changes aren’t helping, your child is in significant pain or if they are bleeding from their bottom. […] Constipation can usually be controlled with healthy bowel habits and medicines, as advised by a doctor.

• #1

  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.

• #1 Constipation in Children: Novel Insight Into Epidemiology, Pathophysiology and Management

  https://www.jnmjournal.org/journal/view.html?volume=17&number=1&spage=35

  Constipation in Children: Novel Insight Into Epidemiology, Pathophysiology and Management […] Constipation is one of the commonest digestive complaints in children, which has recently grown to quite a proportion in public health problem. […] This article focuses on current views on definition, epidemiology, clinical features, evaluation and management strategies of constipation in children. […] Several risk factors have been identified in association with pediatric constipation. The main risk factors for constipation are listed in Table 2. […] Low consumption of dietary fiber has long been considered as one of the leading risk factors. […] Therefore, it is important to use diagnostic criteria based on multiple symptoms to define constipation. […] Management of constipation encompasses several facets. However, only few randomized controlled trials are available to assess therapeutic options currently being used in treatment. […] The key steps in management include education and demystification, treatment of fecal impaction, maintenance therapy and close follow-up. Steps in management of childhood constipation are illustrated in the Figure.

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

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

  Children need to sit on the toilet two to three times each day for five to 10 minutes each time. […] Most important, always be positive and never punish or scold a child who is toilet training or having difficulty with bowel movements. […] Treatment of children with chronic constipation is necessary to reduce their risk of developing other complications such as: hemorrhoids, anal fissures, rectal prolapse, fecal impaction, and long-term constipation leading to diverticulitis as an adult. […] The best way to start off treatment of a constipated child is to evacuate the old stool from the rectum and colon. […] Maintenance treatment should continue for at least two months, if not longer. […] It is important to speak with your child’s primary care doctor about their constipation when episodes of constipation last longer than three weeks and dietary changes or adding hydration has not helped. […] In most cases, your child’s pediatrician can manage constipation. If, with treatment, the child’s constipation does not go away, talk to the child’s doctor about seeing a pediatric gastroenterologist.

• #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. […] Read on for more information about constipation (signs and symptoms, causes and treatment) and how to help your child develop good bowel habits. […] 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. When the body does not get enough water, it becomes dehydrated and takes water from the gut and pushes it to other important places in the body, like the heart. This can be what starts the cycle to make poops harder. Increasing a child’s water intake without medicines is not an effective treatment for constipation.

• #2 Constipation in children, paediatrics (540) | Right Decisions

  https://rightdecisions.scot.nhs.uk/shared-content/ggc-clinical-guidelines/paediatrics/emergency-medicine/constipation-in-children-paediatrics-540/

  Constipation can present at three common stages of childhood: in infancy at weaning, in toddlers acquiring toilet skills, at school age. […] Most children have no underlying organic cause for constipation i.e. they have functional constipation. […] Aim to empty bowel, keep bowel empty and prevent recurrence. […] Treatment starts with education of parents/carers and children (as appropriate for age). […] Ensure adequate fluid intake. […] Ensure adequate diet/fibre -?refer to dietitian if necessary. […] Regular toileting. […] Behavior modification: toilet training/rewarding/toilet diaries etc.

• #2

  https://link.springer.com/article/10.1007/s40746-020-00193-5

  Constipation Is a common pediatric symptom that can affect children of all ages. […] Guidelines from several medical societies for the evaluation and treatment of a child presenting with constipation have been published. […] It has become increasingly clear that early treatment of functional constipation is associated with improved long-term outcomes. […] Childhood constipation Requires a comprehensive therapeutic plan, comprised of education, behavioral intervention, and medication that jointly produce effective defecation. […] These children Are best evaluated in specialized centers that offer a multi-disciplinary approach to both the physical and psychosocial components of chronic constipation treatment. […] Finding from this study reveal that children with chronic constipation have sensory characteristics that contribute to difficulties at the time of toilet training. By identifying such sensory processing changes, medical providers may be able to optimize behavioral interventions to complement use of laxatives in this population.

• #2 Constipation in Children: Symptoms, Causes, and Treatment

  https://patient.info/digestive-health/constipation/constipation-in-children

  Constipation is a very common problem for children. […] It is important that constipation be recognised early to prevent it from becoming a long-term (chronic) problem. […] You can help prevent constipation in your child by making sure they are eating foods with plenty of fibre and drinking plenty. This makes stools (faeces) that are bulky soft and easy to pass out. Getting plenty of exercise is also thought to help. […] Dietary measures should not be used on their own to treat idiopathic constipation, as it will be unlikely to solve the problem. However, it is still important to get a child into a habit of eating a good balanced diet. This is to include plenty of drinks (mainly water) and foods with fibre. This will help to prevent a recurrence of constipation once it has cleared. […] The Association of UK Dietitians recommends normal daily fibre intake (from the age of 2 years) should be as follows: Age 2-5: 15 g fibre per day. Age 6-11: 20 g fibre per day. Age 12-15: 25 g fibre per day. Age 16+: 30 g fibre per day.

• #2 Remedies for Constipation in Children – CHOC – Children’s health hub

  https://health.choc.org/remedies-for-constipation-in-children/

  Constipation in children is an all-too-common ailment, accounting for nearly five percent of all pediatric visits each year and one out of every four pediatric gastroenterology visits. More than 90 percent of constipated children have “functional” constipation, meaning constipation without any underlying disease. […] The most common cause of constipation in children is withholding due to past experience with painful passage of stools, says Dr. Ashish Chogle, pediatric gastroenterologist at CHOC. Other leading factors relate to water and food intake. […] There are several things parents can try at home to alleviate the problem of constipation, he says. First, if your child is not usually a keen water drinker, increase their water intake to normal levels. CHOC recommends one full eight ounce glass of fluids per year in age every day. Increasing their fiber intake can also help relieve mild cases of constipation in children. Good sources of fiber include whole grains, whole wheat items, beans, green leafy vegetables and fruit. The minimum amount of fiber for children is equal to your child’s age plus five grams. For example, a child who is 5 years old should eat 10 grams of fiber each day (5 years + 5 = 10 grams). If the child isn’t better after trying these methods at home, consult your pediatrician. Your pediatrician may recommend a treatment plan or refer you to a pediatric gastroenterologist.

• #2 Constipation Treatments and Prevention for Children Age 11 and Younger

  https://www.webmd.com/children/constipation-treatment

  A high-fiber diet with plenty of fluids. This means loading your childs plate with plenty of fresh fruits and vegetables, high-fiber cereals, whole grain breads (look for at least 3-5 grams of fiber per serving), and a variety of beans and other legumes, like chickpeas and lentils. […] A stool softener to clear the bowels. These are typically safe in children. […] Regular toilet time. Encourage your child to use the toilet first thing in the morning and after every meal or snack. […] You’ll get the best results if you combine all three of these approaches. A high-fiber diet isnt likely to clear up a serious case of constipation on its own without the help of a stool softener; on the other hand, once your child stops taking a stool softener, if they stay on a low-fiber diet and doesnt get enough healthy fluids, the problem is likely to happen again.

• #2 Home Remedies for Constipation in Kids

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

  Constipation in kids is extremely common, affecting roughly 30-35% of children. […] If you think your child is constipated, Dr. Granger lists safe and easy options for quick relief at home: […] 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. […] 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. […] Feed your child a diet rich in fiber by aiming for five servings of fruits and vegetables each day. […] Excess dairy intake, especially milk, can cause constipation. […] 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.

• #2 Constipation in Children: Symptoms, Causes, and Treatment

  https://patient.info/digestive-health/constipation/constipation-in-children

  If a bottle-fed baby has a tendency to become constipated, you can try offering water between feeds. […] Encourage children to drink plenty. However, some children get into the habit of only drinking squash, fizzy drinks or milk to quench their thirst. […] Try to get children into a regular toilet habit. After breakfast, before school or nursery, is often best. […] Toilet training should be relaxed. […] Encouraging your child is helpful. Some kind of reward system is sometimes useful in younger children prone to holding on to stools. […] Try to keep calm and not make a fuss over the toilet issue.

• #2 Constipation in Kids: Causes and Treatment – Children’s Health

  https://www.childrens.com/health-wellness/constipation-in-kids

  Stay physically active: One of my colleagues says theres no such thing as a constipated runner, Dr. Sanghavi says. Make sure your child gets 30 to 45 minutes of moderate exercise throughout the day. […] If you have applied the three pillars and your child is still constipated, you should see a pediatrician. The first line of treatment is usually mild laxatives and further modification of diet, says Dr. Sanghavi. […] Although some parents might be concerned about the use of laxatives in children due to recent publicity about MiraLAX, Dr. Sanghavi says laxatives are generally safe and effective for treating constipation in kids.

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

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

  Quality of life scores are lower in children with chronic constipation than those without constipation. […] 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. […] Some studies have shown that combining medical and behavior therapy can improve fecal incontinence and other clinical outcomes. […] Clinicians should acknowledge the possible negative effects of functional constipation on the child’s parents or caregivers. […] For children presenting with fecal impaction, removing the hard stool from the colon is the first step in treating constipation.

• #2 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. […] 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. […] Education is as important as medical therapy in successfully managing functional constipation. […] Recognize withholding behaviors and use behavioral interventions: Regular toileting. Tell parents that the child is to sit on toilet 2 to 3 times daily, 5 to 10 minutes each, for protected time to have a BM. Ensure that smaller children have a step stool so feet touch solid surface. […] Recommend normal fiber and fluid intake for age. Addition of prebiotics and probiotics to the regimen is not currently supported by adequate evidence. […] Emphasize if families are having difficulties, they should follow up to discuss referral to a pediatric gastroenterologist.

• #2 Constipation in Kids: Symptoms, Remedies, and Medical Treatment

  https://www.healthline.com/health/constipation-in-kids

  Here are a few tips to help prevent constipation in babies, toddlers, and children: […] Aim to serve more high fiber foods, such as beans, whole grains, fruits, and vegetables. […] Increase your child’s water intake to at least 1 liter (32 ounces) a day. […] Encourage physical activity, such as riding a bike, kicking a ball, or walking the dog. […] Teach your child not to ignore the urge to have a bowel movement. […] Help your child develop a pattern of using the bathroom after meals. Have them sit on the toilet for about 10 minutes after eating so that bowel movements become a regular part of their routine.

• #2

  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. A recent study showed that the potty stool is safe and effective (when used with medicines) to treat functional constipation in toilet-trained children. […] There is research showing that children and parents benefit from receiving a Constipation Action Plan at the time of diagnosis. These plans help parents understand what amounts (doses) of medicines to give at what times, and, if need be, to give larger doses in response to worsening symptoms.

• #2 Paediatric constipation: An approach and evidence-based treatment regimen

  https://www1.racgp.org.au/ajgp/2018/may/paediatric-constipation

  Constipation affects 530% of children and is responsible for 3% of primary care visits. […] It is important to initiate a clear management plan for the family, as what is an easily treatable condition can escalate into a vicious cycle of pain if not addressed early. The medical approach should consider organic disease, the use of appropriate toileting habits, and dietary modifications. Laxatives are often required to re-establish regular, painless defaecation. […] Normal fibre intake, fluid intake and exercise are recommended for children with constipation. Fibre supplements are not recommended. […] For children who are not yet toilet-trained for stool, and who feel more secure defaecating in a diaper, this should be encouraged while the stool is softened with laxatives and the child regains confidence. Toilet training should be child-led. Routine is important; if old enough to comply, children should be encouraged to sit on the toilet for five minutes after every meal. This can be used in conjunction with a rewards program such as a star chart.

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

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

  Encouraging healthy toilet habits – If your child is toilet trained, encourage them to sit on the toilet for approximately 10 minutes once or twice a day after eating. The child is more likely to have a bowel movement after a meal, especially breakfast. […] BEHAVIOR CHANGES […] In children who have constipation frequently, behavior changes are recommended to help the child develop normal bowel habits. […] – Encourage your child to sit on the toilet within 30 minutes after each meal (ie, for 10 minutes two to three times per day). Do this every day if possible. […] – Design a reward system with your child to recognize the child’s efforts. Give the reward after the child sits, even if they do not have a bowel movement. […] – Keep a diary of your child’s bowel movements, medicines, pain, and accidents. This will help you and your child’s doctor or nurse figure out if there are triggers for constipation.

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

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

  Childhood constipation is common and almost always functional without an organic etiology. […] Successful therapy requires prevention and treatment of fecal impaction, with oral laxatives or rectal therapies. […] An increase in dietary fiber may improve the likelihood that laxatives can be discontinued in the future. Education is equally important as medical therapy and should include counseling families to recognize withholding behaviors; to use behavior interventions, such as regular toileting and reward systems; and to expect a chronic course with prolonged therapy, frequent relapses, and a need for close follow-up. […] Dietary changes are often advised in children with constipation. An increased intake of fluids and absorbable and nonabsorbable carbohydrates (e.g., sorbitol in prune, pear, and apple juice) can help soften stools, particularly in infants.

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

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

  Disimpaction can be achieved by using oral or rectal medications. […] 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. […] Maintenance therapy should be continued for at least two months or at least one month after a good response to treatment. […] Relapses are common and should be treated with maintenance therapy or disimpaction therapy when appropriate. […] After constipation is diagnosed and the treatment plan is determined, frequent follow-up is recommended to ensure that disimpaction has been achieved and that maintenance therapy is effective. […] Clinicians should educate caregivers about functional constipation’s chronic course and frequent relapses, and the possible need for prolonged therapy.

• #2 Pediatric Constipation: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/928185-overview

  Constipation in children has reported prevalence rates between 1% and 30%. It is the principal complaint in 3-5% of all visits to pediatric outpatient clinics and as many as 35% of all visits to pediatric gastroenterologists. […] For practical clinical purposes, constipation is generally defined as infrequent defecation, painful defecation, or both. In most cases, parents are worried that their child’s stools are too large, too hard, not frequent enough, and/or painful to pass. […] It is very important to educate the family that using laxatives continuously for months may be necessary. This is particularly true in toddlers, because many months may pass before their association between the fear of pain and defecation is extinguished. […] Caregivers should be reassured as to the safety of long-term laxative use, and the importance of persistent treatment should be strongly reinforced. Address the common misconceptions about laxative dependency and the increased risk of colon cancer due to long-term laxative usage. […] Inform the family that relapses are common and are often associated with changes in the child’s daily routine (eg, vacations) or during times of stress. Also, inform the family that the requirement of intermittent therapy with laxatives into adulthood is not unusual.

• #2 NHS England » National clinical constipation pathway for primary care for children

  https://www.england.nhs.uk/long-read/national-clinical-constipation-pathway-for-primary-care-for-children/

  Children with disabilities are more prone to constipation than their typically developing peers. It must be treated proactively to prevent long-term morbidities and potential mortality in the young person or young adult with a learning disability. […] Continued provision of prescriptions for laxatives is essential to allow the bowel to recover and prevent withholding due to fear of painful bowel actions. […] Acute constipation (history of less than four weeks) often needs proactive ongoing, preventative treatment so that it does not become chronic due to pain on bowel opening resulting in fear and withholding. […] Regular follow up improves outcomes. Family should be contacted one week after commencing disimpaction, two weeks after commencing maintenance, then within a further four weeks and then within eight weeks. Further follow up should continue as appropriate to the child and family. […] Reassess as appropriate to the child and family. If no improvement after three months refer to specialist service (local childrens bladder and bowel service if there is one or to a paediatrician).

• #2

  https://www.eirmc.com/healthy-living/blog/constipated-kids-prevention-tips-and-when-to-see-a-doctor

  Constipation is a common problem among children of all ages. […] If you think that your child might be constipated, follow our prevention tips and find out when to see a doctor. […] For kids aged one through 18, here are some ways to help prevent constipation: […] Ensure proper fluid intake […] Kids aged 8 and up should drink about 64 ounces of fluids daily. […] Ensure proper fiber intake […] Good sources of fiber include whole grains, non-starchy vegetables, whole fruits, beans, legumes, nuts and seeds. […] Ensure proper potty posture […] Be aware that some children dont want to interrupt their playtime to have a bowel movement, so be sure kids spend enough time on the toilet. […] Encourage daily physical activity […] According to the CDC, children aged 3 through 5 need to be active throughout the day; children and adolescents aged 6 through 17 need to be active for 60 minutes every day. […] If your child has symptoms that last more than two weeks or have not been resolved by the diet and exercise recommendations above, you should make an appointment with your pediatrician.

• #2 Pediatric Constipation Treatment & Management: Approach Considerations, Colon Evacuation, Removal of Pain-Associated Defecation

  https://emedicine.medscape.com/article/928185-treatment

  Dietary changes, such as increasing the child’s intake of fluids and carbohydrates, are commonly recommended as part of the treatment of constipation. […] In infants and young children, it is appropriate to consider removing cow-milk protein from the diet for a period is appropriate, because chronic constipation may be precipitated by ingestion of cow-milk proteins. […] Consultation with a pediatric gastroenterologist or pediatric surgeon is appropriate if the child’s history or examination findings suggest an underlying organic cause (eg, Hirschsprung disease). […] Assessment of constipation after disimpaction assures that the prescribed therapy was effective. At that time, maintenance laxative therapy can be prescribed.

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

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

  Studies have shown that children with constipation have a lower fiber intake than other children. An increased intake of dietary fiber may improve the likelihood that a child will be able to discontinue laxative therapies. […] 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. […] Although behavior modification and education are important, intensive behavior therapy does not seem to add to treatment success, except in rare cases in which the patient has underlying behavior problems. […] 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.

• #2 Constipation in Children – American College of Gastroenterology

  https://gi.org/topics/constipation-in-children/

  If constipation does not get better with dietary and behavior modifications, stool softeners are indicated. The two most common stool softeners used in children are polyethylene glycol 3350 and lactulose. […] Polyethylene glycol has become the most widely used medication for treating constipation in children. It is a white powder that can be dissolved in juice, water or other liquids and does not get absorbed by the body. It is tasteless, safe and non-habit forming. Children have soft, more frequent stools on this medication. […] Surgery is rarely needed for constipation. The exception to this is Hirschsprung’s disease, which is treated with surgical removal of the portion of the bowel where there are no normal nerves.

• #2 Constipation (for Parents) | Nemours KidsHealth

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

  Constipation is a very common problem in kids. It usually isn’t a cause for concern. Healthy eating and exercise habits can help prevent it. […] To prevent and treat constipation: […] Give your child more liquids. Drinking enough water and other liquids helps poop move more easily through the intestines. […] Make sure your kids eat more fiber. High-fiber foods (such as fruits, vegetables, and whole-grain bread) can help prevent constipation. […] Encourage your kids to get enough exercise. Physical activity helps the bowels get into action, so encourage your kids to get plenty of exercise. […] Develop a regular meal schedule. Eating is a natural stimulant for the bowels, so regular meals may help kids develop routine bowel habits. […] Get kids into the habit of going. If your child fights the urge to go to the bathroom, have them sit on the toilet for at least 10 minutes at about the same time each day (ideally, after a meal).

• #2 Constipation in Children: Novel Insight Into Epidemiology, Pathophysiology and Management

  https://www.jnmjournal.org/journal/view.html?volume=17&number=1&spage=35

  The general public has various concepts on constipation which may interfere with proper clinical management. Therefore educating the parents and patients about pathophysiology and precipitating factors will help to alleviate anxiety, minimize accusations and increase their involvement in management. […] Behavioral therapies for constipation are designed to regularize toilet routines, discourage stool withholding and improve understanding of defecation dynamics. […] […] Evacuation of feces accumulated in the rectum is the key therapeutic step in successful management of constipation. […] After achieving disimpaction it is vital to start daily oral laxatives to keep the stool soft thereby to prevent re-impaction. […] The duration of the maintenance phase needs to be individualized and may vary from months to years.

• #3 Remedies for Constipation in Children – CHOC – Children’s health hub

  https://health.choc.org/remedies-for-constipation-in-children/

  Constipation in children is an all-too-common ailment, accounting for nearly five percent of all pediatric visits each year and one out of every four pediatric gastroenterology visits. More than 90 percent of constipated children have “functional” constipation, meaning constipation without any underlying disease. […] The most common cause of constipation in children is withholding due to past experience with painful passage of stools, says Dr. Ashish Chogle, pediatric gastroenterologist at CHOC. Other leading factors relate to water and food intake. […] There are several things parents can try at home to alleviate the problem of constipation, he says. First, if your child is not usually a keen water drinker, increase their water intake to normal levels. CHOC recommends one full eight ounce glass of fluids per year in age every day. Increasing their fiber intake can also help relieve mild cases of constipation in children. Good sources of fiber include whole grains, whole wheat items, beans, green leafy vegetables and fruit. The minimum amount of fiber for children is equal to your child’s age plus five grams. For example, a child who is 5 years old should eat 10 grams of fiber each day (5 years + 5 = 10 grams). If the child isn’t better after trying these methods at home, consult your pediatrician. Your pediatrician may recommend a treatment plan or refer you to a pediatric gastroenterologist.

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