Abstract
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.