[Constipation in infants and children: How should it be treated?]

Area of Science:

• Pediatric Gastroenterology
• Digestive Health
• Clinical Pediatrics

Background:

• Functional constipation is a prevalent pediatric issue, often leading to delayed treatment and significant psychosocial and digestive complications.
• Current management strategies for pediatric constipation require clear, codified, and effective approaches to mitigate long-term effects.

Purpose of the Study:

• To outline effective, evidence-based treatment protocols for functional constipation in children.
• To differentiate appropriate therapeutic options based on age and severity, including fecal impaction.

Main Methods:

• Review of established treatment guidelines for pediatric functional constipation.
• Analysis of age-specific medication efficacy, including lactulose, lactitol, and polyethylene glycol (PEG).
• Emphasis on the importance of fecal disimpaction, toilet training, and psychological support.

Main Results:

• Lactulose/lactitol are effective before 6 months; polyethylene glycol (PEG) is indicated for infants over 6 months.
• Sufficient dosage and prolonged treatment duration are critical for managing established constipation.
• Fecal disimpaction using high-dose PEG or phosphate enemas is the primary step for impaction cases.

Conclusions:

• Established pediatric constipation requires sustained treatment with age-appropriate medications like PEG.
• Comprehensive management includes fecal disimpaction, toilet habit education, and psychological support to prevent relapse.
• Hyperosmotic mineral water, diet, and endoanal medications are not primary treatments for established constipation.