From the Research
Discharge Instructions for Functional Constipation in Children
The discharge instructions for a child with functional constipation should include the following:
- Explanation of the condition and its treatment options 1
- Disimpaction and maintenance therapy consisting of diet changes, behavioral modification, and the use of laxatives 1, 2
- Dietary interventions, such as adequate fiber and fluid intake 3, 2
- Toilet training and frequent toileting to recondition normal bowel habits 1, 4, 2
- Use of oral laxatives, such as polyethylene glycol 3350, as the first-line treatment for disimpaction and maintenance therapy 1, 5, 2
- Avoidance of enemas and rectal medications, except in cases of severe rectal impaction 1
- Follow-up appointments to monitor progress and adjust treatment as needed 1, 2
Key Considerations
- Treatment should be individualized to the child's needs and preferences 1
- Good communication between the healthcare provider, child, and parents is essential for successful treatment 1
- Early intervention with oral laxatives may improve complete resolution of functional constipation 1
- Comorbid psychological disorders should be assessed and treated additionally according to evidence-based guidelines 5
Medication Management
- Polyethylene glycol 3350 is the recommended first-line medication for disimpaction and maintenance therapy 1, 2
- Lactulose is a preferred alternative if polyethylene glycol is not available or is poorly tolerated 2
- Other laxatives may be considered as second-line therapy if treatment with osmotic laxatives fails or is insufficient 2
- Maintenance treatment should be continued for at least 2 months 2