Management of Functional Constipation.


eMediNexus Editorial    06 July 2018

A new study published in Indian Pediatrics aimed to formulate comprehensive practice guidelines for the management of childhood functional constipation relevant to the Indian population.

The process involved a questionnaire-based survey conducted among selected practicing pediatricians and pediatric gastroenterologists in India, wherein the respondents agreed on the need to establish an Indian guideline for the management of functional constipation.

A consensus was arrived upon. Therein, it was recommended that functional constipation should be diagnosed only in the absence of an established cause for constipation on history and examination. It was suggested that patients with fecal impaction and/or retentive incontinence should be disimpacted with polyethylene glycol. Osmotic laxatives, such as polyethylene glycol should be used in the first line for maintenance therapy. While stimulant laxatives should be reserved only for rescue therapy. On the other hand, combination therapies with two osmotics, two stimulants or two classes of laxatives were not recommended. Meanwhile, a long-term use of laxatives were recommended as maintenance therapy which could be tapered off gradually, only after a successful outcome. Furthermore, essential components of therapy, like counselling, dietary changes, toilet-training and regular follow-up were indicated for a successful outcome.

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