What are some medications for constipation in kids?

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According to the American Academy of Pediatrics (AAP), constipation is a common problem in children, accounting for approximately 1 in 20 pediatric visits.

There are two main types of medication for treating constipation in children: laxatives and enemas. Both help promote or ease bowel movements.

Laxatives

The United Kingdom’s National Health Service (NHS) notes that there are four main types of laxatives. They are:

• Osmotic laxatives: These draw water from the rest of the body into the bowels, softening stool and making it easier to pass. Osmotic laxatives usually work within 48–72 hours. Examples include:
  • lactulose
  • macrogol
  • polyethylene glycol
• Stool softeners: Also known as surfactant laxatives, these increase the water content of stool, making it softer and easier to pass. Examples include arachis oil and docusate.
• Bulk-forming laxatives: These help bulk up the stool, easing its passage through the digestive system. Examples include ispaghula husk and methylcellulose.
• Stimulant laxatives: These stimulate the muscles that line the intestines, helping them move stools through the digestive system. Stimulant laxatives usually promote bowel movements within 6–12 hours and may be appropriate for children who do not respond well to the treatments above or dietary changes. Examples include:
  • bisacodyl
  • senna
  • sodium picosulfate

Enemas

An enema is a treatment that involves inserting a liquid solution directly into the rectum to help soften the stool and promote a bowel movement. Medical professionals may recommend enemas to help treat severe or persistent constipation.

Rectal sodium phosphate is a laxative that people use as an enema. It typically causes a bowel movement within 1–5 minutes and is suitable for children over 2 years of age.

The table below features some common brand-name laxatives alongside their generic name and laxative type.

Glycerin suppositories, such as Pedia-Lax glycerin suppositories, are also safe to use in infants and children. They are an osmotic laxative. However, they can cause rectal skin irritation.

Another treatment option is mineral oil. This is a type of lubricant laxative that is safe to use in children. However, it is not safe for infants, as it can cause lipoid pneumonia if it gets into the lungs, and infants may have difficulty swallowing it.

Stimulant laxatives are not recommended for infants.

People should only ever administer laxatives and enemas according to their doctor’s or pharmacist’s instructions.

Doing so helps ensure that a child is receiving an appropriate type and dose of medication according to their age and overall health status. This, in turn, helps reduce the risk of side effects and complications.

In some cases, constipation may be a sign of an underlying health condition that requires medical attention. A parent or caregiver should contact the child’s doctor if the child experiences any of the following:

• severe or chronic constipation
• additional symptoms, such as:
  • abdominal pain
  • abdominal bloating
  • blood in the stool
  • tiredness and fatigue
  • unexplained weight loss

Below are some home remedies that may help treat constipation in children:

• Increasing water intake: People should encourage children to drink plenty of water throughout the day. This can help soften stool, making it easier to pass.
• Increasing fiber intake: Fiber helps bulk up stools and promotes regular bowel movements. It also draws water into the bowel, so it is important that people who increase their fiber intake also increase their fluid intake to prevent dehydration. Examples of fiber-rich foods include:
  • fruits
  • vegetables
  • whole grains
  • legumes
• Exercising: Exercise helps stimulate bowel movements. Parents and caregivers should encourage children to engage in physical activity, such as playing outside or participating in sports.
• Massaging the abdomen: A 2022 systematic review and meta-analysis notes that abdominal massage may help stimulate the digestive tract and promote bowel movements in children. However, further studies are necessary to confirm these effects.
• Establishing a toilet routine: Parents and caregivers should encourage children to go to the bathroom at the same time each day to help regulate bowel movements and prevent constipation.
• Drinking prune juice: Prune juice is a natural laxative that can help soften the stool and promote bowel movements. Doctor Prasanna Kapavarapu of the Children’s Hospital of Philadelphia recommends that children younger than 4 months receive 1 ounce of prune juice in 1 ounce of water 2–3 times per day, as a treatment for constipation. People should be aware that giving too much juice can lead to excessive sugar intake.
• Consuming psyllium husk: This is a good source of fiber that can act as a beneficial supplement. Read the label on the product for guidance as to age limits.

A person should only use the above home remedies under the guidance of a qualified healthcare professional.

Below are some complementary therapies that parents or caregivers may want to consider in addition to standard constipation treatments for children:

• Probiotics: Probiotics are beneficial bacteria that live in the gut and help promote healthy digestion. A diet rich in probiotics may help relieve constipation. Some good sources of probiotics include:
  • yogurt and kefir
  • traditional buttermilk
  • sour pickles and sauerkraut
  • probiotic supplements
• Massage therapy: Abdominal massage therapy can help stimulate bowel movements and relieve constipation. A trained massage therapist can perform abdominal massage, or parents and caregivers can learn how to perform this therapy at home.
• Herbal remedies: Certain herbs, including senna and slippery elm, may help relieve constipation. However, people should consult a healthcare professional before giving any herbal remedies to children. Herbal remedies can cause side effects and may interact with other medications or supplements the child is taking.
• Chiropractic care: In a 2017 case report, a combination of chiropractic manipulation and gentle reflex therapy helped alleviate constipation in identical 7-month-old male twins who had presented with constipation since birth. However, more research is necessary to determine the effectiveness of chiropractic for constipation.

People should only ever use complementary therapies under the guidance of a doctor or other healthcare professional. Some therapies may cause side effects or may interact with certain medications or supplements.

It is also important that people do not use complementary therapies in place of prescription medications and treatments.

Constipation refers to difficulty passing stools or a reduction in the frequency of bowel movements. Constipation in children is a common problem, accounting for around 1 in 20 pediatric visits.

There are two main medical treatments for constipation in children: laxatives and enemas. Parents and caregivers should only ever administer these treatments according to a doctor’s instructions. Additional treatment options to consider include dietary changes, probiotic supplements, and regular exercise.

In some cases, constipation can indicate an underlying condition that requires medical attention. Parents and caregivers should notify their child’s doctor if the child experiences severe or persistent constipation or additional symptoms, such as abdominal pain, bloating, or blood in the stool.