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. 2015 Oct;17(5):349-60.
doi: 10.1007/s40272-015-0142-4.

Management of Functional Constipation in Children: Therapy in Practice

Affiliations

Management of Functional Constipation in Children: Therapy in Practice

Ilan J N Koppen et al. Paediatr Drugs. 2015 Oct.

Abstract

Functional constipation is a common healthcare problem among children worldwide and accounts for high healthcare usage and costs. Functional constipation is a clinical diagnosis; the evaluation primarily consists of a thorough medical history and a complete physical examination. Additional investigations are not necessary in most cases. Treatment consists of non-pharmacological and pharmacological interventions. Non-pharmacological interventions involve education and demystification, toilet training (with a reward system), and a defecation diary. Pharmacological treatment comprises three steps: disimpaction, maintenance treatment, and weaning. The treatment of first choice is oral laxatives, preferably polyethylene glycol. When this is insufficient, other therapeutic agents are available. This review discusses the evaluation and management of functional constipation in the pediatric population and provides a summary of drug treatment options.

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Figures

Fig. 1
Fig. 1
Flowchart of evaluation and management of functional constipation in children. 1Ensure adequate fiber and fluid intake. 2Polyethylene glycol (PEG) is recommended as the first choice for disimpaction. 3Medications and dosages can be found in Table 2. 4PEG is recommended as the first choice for maintenance treatment. 5The first evaluation should be scheduled after 2 weeks

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