Management of Functional Constipation in Children

Constipation is a common problem in children and almost 95% of them are functional. A detailed history, and physical examination including per rectal, along with checking for presence of red flags is essential to differentiate functional from organic etiology. Disimpaction followed by maintenance therapy with laxatives, dietary advice and behavioral therapy is the mainstay of management. Prolonged therapy over months and sometimes years is required. Most protocols are largely experience based with very little published evidence based guidelines. Education of parents and long term therapy with regular follow-up is a must to ensure success. Children who are refractory to therapy despite compliance, need referral to a specialist for investigations to rule out organic diseases.