Thursday, April 30, 2015

Office management of Constipation in Children - 4 Simple & Important points for Child Specialists & parents

Q: Which is preferred first line medicine for constipation in children.. liquid paraffin vs sodium picosulfate vs lactulose vs macrogol 4000 vs PEG ??? also the dose of each drug ??? any contraindications to their use ?? most important question --  how long to use ??
other advise apart from plenty of water intake, fruits ,veggies, milk restriction ???

90% of constipation in children is functional.before that we have to R/o organic cause .
Steps in management.
1.Consumption of dietry fibres and fluids.
2.Timed pattern of stooling:15 to 30 mts after feeding utilising the gastro colic reflux.
3.Then comes pharmacotherapy in the order of 

a).PEG 3350
b).Lactulose 1-3ml/kg/day in divided doses(maximum dose should not cross the adult doses (i.e 30 ml) ANother option is Sodium Picosulfate as a second line therapy. It is a stimulant with an excellent safety profile and better tolerated with good effect.
4.Duration: 2 to 4 wks and reassess

Source: Discussion on

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