Therapy for refractory constipation in children 1 year or older
If constipation does not improve with initial therapy, refer the child to a paediatrician or a paediatric gastroenterologist. While awaiting specialist review, consider adding a stimulant laxative. Suitable regimens include:
1bisacodyl orally bisacodyl bisacodyl bisacodyl
child 3 to 12 years: 5 to 10 mg orally, at night
child older than 12 years: 5 to 15 mg orally, at night
OR
1bisacodyl rectally bisacodyl bisacodyl bisacodyl
child 1 to 2 years: 5 mg rectally, daily
child older than 2 years: 5 to 10 mg rectally, daily
OR
child 2 to 5 years: 3.75 to 7.5 mg orally, at night
child 6 to 12 years: 7.5 to 15 mg orally, at night
child older than 12 years: 7.5 to 30 mg orally, at night
OR
2sodium picosulfate 7.5 mg/mL liquid2 sodium picosulfate sodium picosulfate sodium picosulfate
child 1 to 3 years: 0.25 mg/kg up to 5 mg (10 drops) orally, at night
child 4 years or older: 2.5 to 5 mg (5 to 10 drops) orally, at night.
The onset of action of the oral preparations listed above is 6 to12 hours. For bisacodyl suppositories, the onset of action is 15 to 60 minutes, and for the enema it is 5 to 20 minutes.
Colicky abdominal pain is a common adverse effect of stimulant laxatives.