A new study published in the Journal of Paediatrics and Child Health aimed to determine the etiological spectrum and clinical features to differentiate organic from functional constipation (FC), and assessed the efficacy of polyethylene glycol (PEG) in the treatment of childhood constipation.

This study enrolled 316 consecutive children up to 18 years of age with constipation. Among these, 72% were males and the median age of the participants was 44 months. FC was defined by the Rome III criteria. Standard treatment protocol – disimpaction with PEG followed by laxatives, was adopted for FC. Lactulose was used in the first 4 years of study whereas PEG was given in the last 4 years.

Overall, 77.5% patients were detected with FC, Hirschsprung’s disease being the most common organic cause. The results revealed that the passage of meconium, growth failure, absence of retentive posturing and absent fecal impaction significantly correlated to an organic etiology. In children with FC, successful outcome at 3 months was 81% with PEG and 76% with lactulose. However, a higher number of children in the lactulose group experienced lack of efficacy with the treatment.

Hence, it was inferred that FC is the most common cause of constipation in children. Presence of delayed passage of meconium, growth failure and absence of retentive posturing and absent fecal impaction hint towards an organic cause for constipation. PEG therapy is better that lactulose since, PEG rarely requires a change in intervention and is efficacious in a majority of pediatric patients.