dr Mridul Chandra Das
Pediatric Gastroenterologist
Centre for Child Health, BLK Super Speciality Hospital
About Author

  • Parent counselling – Explain about the treatment plan and importance of adherence of therapy.
  • Diet – Encourage diet rich in fibres with plenty of water & reduce milk intake.
  • Toilet training – Must sit on toilet seat for 3-5 minutes after every major meal.
  • Pharmacotherapy  - Aim at Disimpaction of stools loaded in rectum & Regular emptying of Rectum to avoid repeated rectal impaction

Dis-impaction: 50 - 70% of children with functional constipation have impacted stool at presentation. Impacted stool is diagnosed by digital rectal examination (hard stool in rectum) or palpable fecolith on abdominal examination. Dis-impaction is must in all patient with impacted stool for good outcome. It is done with Polyethylene glycol (PEG) .

Hospital based dis-impaction with PEG solution(made with 137.15 gm in 2 litres water) in dose of 25 mL/ kg/ h oral or by nasogastric tube if patient not able to take orally.

Home based dis-impaction can be done in older child with PEG in a dose of 1.5-2 gm/ kg/ d in two divided doses for 3-6 days.

After dis-impaction child should be put on maintenance therapy which should be continued for at least 3 to 6 months.

Maintenance Therapy

Lactulose (1-2 ml/kg/day of 20%) is the drug of choice in children less than 1 year and PEG(dose 0.8 to 1 gm/kg/day), in more than 1 year of age is the drug of choice for maintenance therapy.



Posted On: 19/04/2019

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