Chronic constipation in children

Constipation is one of the common complaints for which children present to paediatricians and paediatric gastroenterologists. In up to

95 % of the cases, the problem is functional constipation. Early defaecation difficulties, resulting in pain, fear and refusal to use the potty

or lavatory, may lead to creating a vicious cycle with stool retention in the rectum, which may then be accompanied by encopresis. The

management of chronic constipation requires a long-term approach with several phases: education and psychological guidance, removal

of the retained stool and maintenance therapy in order to prevent further retention. Therapeutic advances include the use of novel

osmotic agents such as polyethylene glycol (macrogol 4 000). In a meta-analysis of randomized comparative clinical trials, polyethylene

glycol was shown to be more effective than lactulose. Polyethylene glycol is not fermented by the bacterial microflora in the colon, the

production of gas is not increased and, thus, flatulence is less frequent compared to lactulose.

Keywords: chronic constipation, polyethylene glycol, macrogol