In the expert opinion article Functional Constipation in Childhood: Current Pharmacotherapy and Future Perspectives, current laxative therapies used for pediatric patients were reviewed. Although there are healthcare providers who feel children will “grow out of” their constipation, studies show that constipation can actually have a long term impact on quality of life. Treating constipation usually starts with a clean out of the colon, and it has been proven that children who are treated with a disimpaction prior to maintenance laxatives are more likely to respond to treatment than those who use maintenance laxatives alone.
The article found few studies comparing disimpaction with oral therapies versus enemas; however in the studies that were reviewed, disimpaction with oral laxatives seemed to often be preferred because it is assumed to be less invasive and traumatic. Parents should know, however, that treatment with an enema may relieve symptoms faster than with polyethylene glycol. Studies did show that among children who were treated orally compared to rectally, there was no difference in the amount of reported fearful behavior or struggle to administer the medication.
Many forms of maintenance laxative therapy were discussed, including osmotic laxatives (lactulose), polyethylene glycol, magnesium salts, fecal softeners (docusate, mineral oil), stimulant laxatives (senna, bisacodyl), and rectal laxatives (phosphate, docusate). There is little evidence that shows one therapy or treatment is better than others; all have proven to be effective and use is based on physician preference. Taking into account the specific needs and situation of the patient is important as what will work for some individuals will not work as well for others.
The article noted that a certain amount of children with functional constipation may not find success with the current options in laxative treatment. It discussed some of the challenges to pediatric studies and emphasized the need for more studies in children to be able to determine potential benefits of new therapies that are being studied with promising results for adults.
The UCanPoopToo program offers additional information on clean out regimens and maintenance laxative therapy presented in a kid-friendly, interactive manner that allows both parents and children to relate. Other aspects are addressed as well including toileting, diet, hygiene, social issues and much more. To learn more about how the UCanPoopToo program may benefit your child, visit ucanpooptoo.com.