1 Year and Older // New-onset constipation
Constipation lasting <8 weeks
- Parental Education: age appropriate toileting habits, dietary
- Laxative Therapy
- Pts with hard stools and straining but minimal pain and no withholding behavior, bleeding, or anal fissure, dietary changes may be sufficient
- Optimize fiber intake > 3g per serving
- Pts with stool-withholding behavior, pain while defecating, rectal bleeding, or anal fissure, we suggest initial treatment with PEG with or without electrolytes
- recommended dose of PEG is 0.4 g/kg/day
- fecal impaction: higher dose of PEG (1 to 1.5 g/kg/day) for a maximum of six consecutive days - Disimpaction: higher dose of oral laxative for up to one week, or a sodium phosphate enema (using the appropriate-sized enema for the child’s age) followed by an oral laxative.
Refractory / Chronic Constipation
Constipation lasting longer than 8 weeks
- refer to GI