From the Guidelines
For chronic constipation in an 8-year-old child, polyethylene glycol 3350 (MiraLAX) is the recommended first-line medication, typically given at a dose of 17 g daily, as it is a safe and effective treatment option, according to the most recent guidelines 1.
Treatment Approach
The treatment of chronic constipation in children should focus on restoring normal bowel habits and preventing complications such as rectal prolapse, hemorrhoids, and intestinal perforation, as highlighted in a study on health care supervision for children with Williams syndrome 1.
- The initial dose of polyethylene glycol 3350 can be adjusted based on symptom response and side effects.
- In addition to medication, it is essential to ensure the child drinks plenty of water, eats fiber-rich foods, establishes regular toilet routines, and stays physically active.
- If polyethylene glycol 3350 is ineffective, alternatives such as lactulose or milk of magnesia can be considered, as suggested in a study on the pharmacological management of chronic idiopathic constipation 1.
Important Considerations
- It is crucial to consult a pediatrician before starting any medication, especially if symptoms include severe pain, blood in stool, weight loss, or if constipation began very early in life, as these may indicate a need for further evaluation.
- A study on the evaluation and treatment of monosymptomatic enuresis also emphasizes the importance of treating constipation in children, as it can contribute to nocturnal enuresis 1.
- The most recent guidelines on the pharmacological management of chronic idiopathic constipation provide a comprehensive overview of treatment options, including polyethylene glycol 3350, lactulose, and milk of magnesia, and recommend a tailored approach to treatment 1.
From the Research
Treatment Options for Chronic Constipation in Children
- Polyethylene glycol (PEG) is a recommended first-line treatment for chronic constipation in children, as evidenced by studies 2, 3, 4, 5.
- Stimulant laxatives, such as senna, may also be effective in treating chronic constipation in children 3, 5.
- Nonstimulant laxatives, including psyllium and magnesium salts, may be used as alternative treatments 3, 5.
- Increasing dietary fiber and fluid intake may not provide additional benefits for treating constipation 4.
- Probiotics may not be effective in treating constipation 4.
Chiropractic Care as a Potential Treatment Option
- A case report suggests that chiropractic care may be helpful in some cases of chronic constipation in children 6.
- The report describes an 8-year-old boy who experienced immediate and dramatic improvement in bowel function after chiropractic treatment 6.
Safety and Efficacy of Treatment Options
- OTC therapies for chronic constipation, including PEG and stimulant laxatives, have been shown to be safe and effective in children 3, 5.
- Common adverse events associated with laxative use include diarrhea, nausea, bloating, and abdominal pain 3, 5.
- Serious adverse events are rare, and laxatives are generally well-tolerated by children 3, 5.