Approach to management of constipation in children 1 year or older

For children with constipation, the main principles of management are to:

• adequately soften stools to eliminate fear of painful evacuation
• empty the rectum, if impacted, and keep it empty
• encourage good toileting behaviour.

Nondrug measures should be encouraged and may be sufficient to treat mild constipation. If laxative therapy is needed, it should be continued until regular bowel movements occur or toilet training is completed.

Consider referral to a paediatrician or a paediatric gastroenterologist for children with refractory constipation or encopresis (involuntary passage of faeces), as prolonged treatment is often necessary.