Acute constipation, which is characterized by abdominal pain and/or fecal soiling in the absence of a normal bowel movement, causes distress for children and parents alike. Many safe and effective treatments for acute constipation in children are available without a prescription; however, the American Academy of Pediatrics advises parents to start with a call to the child's doctor. A pediatrician or family doctor can rule out more serious problems and recommend the right medication for the child's age and health history.
Stool Softeners
Stool softeners treat both acute and chronic constipation, mainly by improving the consistency of stools and making them easier to pass. In the 2009 edition of "Current Diagnosis and Treatment: Pediatrics," pediatric gastroenterologists Judith M. Sondheimer and Shikha Sundaram explain that two over-the-counter stool softeners, barley malt extract—brand name Maltsupex—and polyethylene glycol—brand name MiraLax—present safe and effective options for both infants and children. A third option, dioctyl sodium sulfosuccinate, is also available, but does not work well for children with voluntary fecal withholding.
Stimulant Laxatives
In moderate-to-severe acute constipation or acute constipation with voluntary fecal withholding, a physician may recommend stimulant laxatives. Standardized extracts of senna fruit such as Senokot syrup or Ex-Lax are considered safe for children, according to Sondheimer and Sundaram, and work by enhancing the muscle contractions that propel stool outside of the bowel. While stimulant laxatives work well, their use must be limited to a few days or they can actually make constipation worse by causing the bowel to become dependent upon them.
Enemas
In severe cases of acute constipation, hard stool may become impacted in the child's rectum. In these cases, the use of an over-the-counter phosphate soda, saline, or mineral oil enema will almost always produce immediate relief. The Constipation Guideline Committee for Pediatric Gastroenterology cautions, however, that a mineral oil enema should always be followed by a phosphate sodium enema. No enema is considered safe for infants due to the risk of bowel perforation.
References
- American Academy of Pediatrics: Constipation
- “Current Diagnosis and Treatment: Pediatrics, 19th ed.;” W.W. Hay et al.(eds); 2009
- "Journal of Pediatric Gastroenterology and Nutrition;" Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition; Sep. 2006
- American Academy of Pediatrics: Common Over-the-Counter Medications
