From the Guidelines
For children experiencing constipation, polyethylene glycol 3350 (PEG-3350) is the recommended laxative option, given its effectiveness and safety profile, as supported by recent guidelines 1. When considering laxatives for kids, it's essential to prioritize their safety, efficacy, and potential impact on their quality of life. The choice of laxative should be individualized based on the child's age, clinical state, and ability to comply with the medication regimen 1. Some key points to consider when selecting a laxative for children include:
- The importance of maintaining adequate hydration, especially in infants and young children 1
- The potential for certain laxatives, such as sodium phosphate, to cause mucosal abnormalities that may resemble inflammatory bowel disease 1
- The effectiveness of PEG-3350 in children, with a typical dose of 1.5 g/kg/d for 4 days before a procedure, and its relatively good tolerance profile 1
- The need for lifestyle modifications, such as ensuring adequate fluid intake, a balanced diet, and regular physical activity, to help manage constipation in children
- The availability of other laxative options, such as dietary fiber supplements, which may be helpful for occasional constipation in older children It's crucial to consult a pediatrician before administering any laxatives to infants under one year or if constipation persists, is accompanied by pain, bleeding, or vomiting, or if the child seems very uncomfortable. The American Gastroenterological Association and the American College of Gastroenterology guideline panel recommends the use of PEG-3350 as a first-line treatment for chronic idiopathic constipation in children, based on its efficacy and safety profile 1.
From the Research
Laxative Options for Kids
- Polyethylene glycol 3350 (PEG 3350) is a commonly recommended laxative for children with constipation, as it is effective and safe for long-term use 2, 3, 4, 5.
- The optimal dose of PEG 3350 for children is around 0.8 g/kg per day, with adjustments made as needed to achieve 2 soft stools per day 2.
- Other laxative options, such as lactulose, Senna, and Bisacodyl, may also be effective, but PEG 3350 is generally considered the first-line treatment 3, 6.
- It's essential to combine laxative therapy with education and behavioral training, including regular toileting and reward systems, to help children manage constipation effectively 6, 5.
Safety and Efficacy
- Studies have shown that PEG 3350 is well-tolerated and effective in increasing stool frequency and improving stool consistency in children with constipation 2, 4.
- PEG 3350 has been found to be safe for long-term use, with no significant adverse effects reported in clinical trials 2, 4.
- Other laxatives, such as stimulant laxatives, may be used as adjunct therapies in specific clinical scenarios, but PEG 3350 is generally considered the safest and most effective option 3.