From the Guidelines
For pediatric constipation, glycerin suppositories are generally recommended as a safe first-line option. The most recent and highest quality study supporting this recommendation is not directly provided in the given evidence, but based on the available information, glycerin suppositories are considered effective for short-term treatment of constipation 1. For children under 2 years, use infant-sized glycerin suppositories (1-1.2g); for children 2-6 years, use child-sized suppositories (2g); and for children over 6 years, adult-sized suppositories (2.5-3g) can be used. Insert the suppository into the rectum and hold the buttocks together for a few minutes to prevent expulsion. Glycerin works by drawing water into the rectum, softening stool and stimulating bowel movement, typically within 15-30 minutes.
Bisacodyl suppositories (5-10mg) may be used for children over 2 years with more severe constipation, but should be used less frequently as they can cause cramping, as noted in various guidelines for constipation management 1. These suppositories should be used temporarily while addressing underlying causes of constipation through increased fluid intake, dietary fiber, and regular toileting habits. If constipation persists beyond a week, is accompanied by severe pain, vomiting, or blood in stool, consult a healthcare provider as this may indicate a more serious condition.
Key considerations for the management of pediatric constipation include:
- Increasing fluid intake to help soften stool
- Adding dietary fiber to promote regular bowel movements
- Establishing regular toileting habits to train the bowels
- Using suppositories like glycerin or bisacodyl as needed for short-term relief
- Monitoring for signs of more serious conditions that may require medical attention
It's essential to prioritize the child's comfort and safety while managing constipation, and to seek medical advice if symptoms persist or worsen over time. The use of suppositories and other treatments should be guided by the most current clinical evidence and tailored to the individual child's needs 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Treatment Options for Pediatric Constipation
- Osmotic laxatives, such as polyethylene glycol 3350 (PEG 3350) and lactulose, are considered the most effective and safe therapy for both long and short term treatment of pediatric functional constipation 2.
- Stimulant laxatives, like Senna and Bisacodyl, probiotics, fiber preparations, enemas, and suppositories can be used as adjunct therapies in specific clinical scenarios 2.
- Dietary changes, medication use, and behavioral modification are also important components of treatment 3.
Use of Suppositories in Pediatric Constipation
- Suppositories can be used as an adjunct therapy for pediatric constipation, particularly in cases where other treatments have failed or are not effective 2.
- However, there is limited evidence on the specific use of suppositories for pediatric constipation, and more research is needed to determine their efficacy and safety in this population.
Alternative Approaches to Pediatric Constipation
- Non-pharmacologic approaches, such as dietary changes, behavioral modification, and mind-body interventions, can be effective in treating pediatric constipation 4.
- Certain supplements, such as prebiotics, probiotics, and fiber, are safe and may be beneficial in treating pediatric constipation, although more research is needed to confirm their efficacy 4.
- Movement and manipulative interventions, such as abdominal massage and acupuncture, show promise in the field of pediatric constipation, but require further study to determine their mechanisms of action and effectiveness 4.