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A child who is already toilet trained has at least 1 accident per week involving a bowel movement. Child demonstrates withholding behavior in which he or she actively tries not to pass a bowel movement. Hard stools; Pain with defecation. For children, the degree of constipation may be scored by the Leech or the Barr systems:
If your child is struggling with regular constipation, Bauer recommends talking to your pediatrician "as understanding the basis for the constipation is key to any treatment plan."
Chronic constipation may be a sign of irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD); a gastroenterologist can recommend both lifestyle changes and medications to help.
Constipation is more concerning when there is weight loss or anemia, blood is present in the stool, there is a history of inflammatory bowel disease or colon cancer in a person's family, or it is of new onset in someone who is older. [12] Treatment of constipation depends on the underlying cause and the duration that it has been present. [4]
Lactulose is a non-absorbable sugar used in the treatment of constipation and hepatic encephalopathy. [3] [4] It is administered orally for constipation, and either orally or rectally for hepatic encephalopathy. [3] It generally begins working after 8–12 hours, but may take up to 2 days to improve constipation. [1] [2]
Mineral oils, such as liquid paraffin, are generally the only nonprescription lubricant laxative available, but due to the risk of lipid pneumonia resulting from accidental aspiration, mineral oil is not recommended, especially in children and infants. [10] [11] Mineral oil may decrease the absorption of fat-soluble vitamins and some minerals. [9]
Pharmacological treatment for children with functional constipation consists of maintenance therapy and faecal disimpaction. High-dose oral polyethylene glycol (PEG) or enemas containing active substances can induce fecal disimpaction, while maintenance therapy is recommended after successful disimpaction to avoid reoccurring stool buildup.
The main use is for treatment of constipation. In surgery it is used for pre-operative evacuation of the bowel. [3] In diagnostic testing it is used before x-ray examinations or physical examinations of the colon. It is safe for use in children. [4] If used in children under 3 years, it is recommended that the nozzle is only inserted half way. [5]
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