Childhood constipation

Pediatrics for Parents, April, 2002

Children with chronic constipation pose a real treatment challenge. In most cases the diagnosis is "functional fecal retention." This means no medical cause is found.

Children with chronic constipation suffer from abdominal cramps, painful bowel movements, and sometimes fecal impaction (total blockage). There are also the social problems--fecal soiling of underclothes, foul odor, and ostracism by peers.

Many different treatments have been tried--stool softeners, laxatives, enemas, behavioral therapy, dietary manipulations, and, in extreme cases, manual removal of the hardened stool.

A recent study of Miralax, a laxative available by prescription only, showed good results in treating this difficult problem. The 40 children in the study suffered with chronic constipation for at least 3 months. The average length of the problem was 3 years. Over 90% of the children had daily fecal soiling.

Four different doses were used. The higher the dose, the greater the success rate of disimpaction (emptying the bowel of stool) with 91% of the children receiving the highest doses achieving disimpaction.

The success rate was related solely to the dose of the medicine. Age, duration of constipation, current use of other medicines, and other factors didn't influence the results.

There were few side effects, mostly mild bloating and gas. The children and parents found them acceptable and not bad enough to cause cessation of the treatment.

When used in high enough doses (1.5 grams of medicine for each kilogram of child's weight given daily for 3 days) Miralax offers long suffering children and their parents a safe and effective way to treat chronic constipation. If you child suffers from this problem, you should discuss Miralax with his/her doctor.

Journal of Pediatrics, 9/02.