Constipation Remedy - What Works?

There are many treatments that act as a constipation remedy, including:

Each of these categories is described in more detail below.

Remember the aim of constipation treatment is for your child to have one soft but formed bowel motion per day.

The Bristol Stool Chart shows how this should look - to view, click here.

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Natural Remedies

The best natural constipation remedy is to prevent constipation in the first place.

Keep an eye on your child's bowel habit. If the stools are hard or she hasn't gone for 2 or 3 days, act then to try and soften the stools (poop, poo).

You can help soften the stools (poop, poo) by:

  • increasing the fluid your child drinks
  • increasing the servings of fruit and vegetables in the diet - aim for 5 servings per day
  • reducing processed and complex carbohydrates in the diet - like junk food
  • giving a daily glass of apple juice or kiwi fruit juice
  • adding prunes to the cereal (or use plums, pears, peaches, apricots instead)
  • reducing the amount of dairy in the diet

Get your child to develop a regular toilet habit by sitting on the toilet for at least 15 minutes per day. It is best if your child sits on the toilet about 30 minutes after a meal.

To start with, encourage your child to sit on the toilet 30 minutes after a meal 2 or 3 times a day for at least 15 minutes each time - even if she doesn't pass a stool, still get her into this habit.

  • Make sure she is comfortable on the toilet - get a stool for her to rest her feet.
  • Ensure her knees are above her hips
  • Encourage her to lean forward and rest her elbows on her knees
  • Teach him/her to push her abdomen out when pushing
  • Make it fun, so read a book if necessary.
  • Make it a habit.

This is as important as any other constipation remedy.

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Stool Softeners

These laxatives act as a constipation remedy by softening the stool and making it easier to pass. Commonly used stool softeners include:

  • Lactulose - dose up to 2 milliliters per kilogram weight per day (2 ml/kg/day) - usually given in 2 doses but in small doses (like 2.5 ml) give once daily Can take up to 48 hours to work. Can cause tummy pain as it draws fluid into the bowel to soften it. I normally start with a dose of about 1 ml/kg/day and divide this into 2 doses, and adjust as necessary. So if you have a 2 year old weighing 12 kg, start with 5 ml twice a day. The dose can be increased up to 12 ml twice a day if necessary
  • Castor Oil - dose 5 ml Rapid action
  • Paraffin Oil - dose 0.5 milliliters per kilogram weight per day (0.5 ml/kg/day) up to a maximum of 1 ml/kg/day
  • More palatable if given cold
  • Docusate sodium (Coloxyl, Colace, Dioctyl) - dose 2.5 milligrams per kilogram weight per dose (2.5mg/kg/dose) given up to 3 times per day
  • Polyethylene glycol 3350 without electrolytes (Movicol)- dose 0.7 milligrams per kilogram weight per day (0.7 g/kg/day) given once daily.
  • There is 17 g of powder in a packet of polyethylene glycol 3350 without electrolytes and about 23 g of powder in a Movicol-Half sachet, so if you have a 2 year old weighing 12 kg, the dose will be 8.4 g which will be half a packet of powder (one third of a packet of Movicol-Half) which you mix in a glass of water or juice once daily.
  • Milk of Magnesia - dose 2 milliliters per kilogram weight per day (2ml/kg/day) given once daily or twice daily in a divided dose. Not tolerated as well as Polyethylene glycol 3350 in studies

It is important that laxatives used as a constipation remedy are used in conjunction with a regular toileting programme.

Get your child to develop a regular toilet habit by sitting on the toilet for at least 15 minutes per day. It is best if your child sits on the toilet about 30 minutes after a meal.

To start with, encourage your child to sit on the toilet 30 minutes after a meal 2 or 3 times a day for at least 15 minutes each time - even if she doesn't pass a stool, still get her into this habit.

  • Make sure she is comfortable on the toilet - get a stool for her to rest her feet.
  • Ensure her knees are above her hips
  • Encourage her to lean forward and rest her elbows on her knees
  • Teach him/her to push her abdomen out when pushing
  • Make it fun, so read a book if necessary.
  • Make it a habit.

To read about how to adjust doses and how long laxatives are required, click here.

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Stool Stimulants (Emptiers)

These act as a constipation remedy by stimulating the bowel to push out the stool (poop, poo).

If your child has had impacted stool and overflow soiling, it is likely the bowel has stretched and has lost some tone, so often a stimulant (emptier) will be needed for a while.

Commonly used stimulants (emptiers) include:

  • Senna (Senokot, Ex-lax, Sure-Lax) - dose 0.5 milliliters per kilogram weight per dose (0.5 ml/kg/dose) if liquid is available given in one dose. 5 ml is equivalent to 7.5 mg senna
    Dose is 0.75 milligrams per kilogram weight per day (0.75mg/kg/day). One tablets is 7.5 mg. This is given just once a day.
    The stimulant action can cause tummy pain.
  • Bisacodyl (Dulcolax) - dose 0.3 milligrams per kilogram weight per day (0.3 mg/kg/day).
    Do not crush or chew tablets
    Do not use for more than a week

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Suppositories

These are used as a constipation remedy in cases where other medications may not be working or to clear the bowel. Examples of suppositories include:

  • Glycerin suppository - dose for infants under 1 year - up to 1 gram.
    For toddlers, dose is 2 grams
    Mainly safe
    Cut suppositories into slivers and lubricate with a water based lubricant (like KY jelly) before passing. Be gentle.
    Don't use as a constipation remedy more than once per day.
  • Microlax enemas (Sodium citrate) - 2.5 ml given once (Half a tube)
    Don't use more than once per day.

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Disimpaction Agents

Use of these agents as a constipation remedy should be supervised by your doctor. They are strong laxatives and include:

  • Sodium Picosulphate (Picoprep)
  • Polyethylene glycol-electrolyte solution (Kleen Prep)
  • Phosphate solution (Fleet)

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References

  • Susan S. Baker, Gregory S. Liptak, Richard B. Colletti, Joseph M. Croffie, Carlo DiLorenzo, Walton Ector, and Samuel Nurko. CONSTIPATION IN INFANTS AND CHILDREN: EVALUATION AND TREATMENT. A medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition
  • G Rubin. Constipation in children. Clinical Evidence. 2006. BMJ Publishing Group
  • Medicines for Children. RCPCH 2003. RCPCH Publications
  • Epocates. www.epocrates.com
  • Vera Loening-Baucke, Dinesh S. Pashankar. Randomized, Prospective, Comparison Study of Polyethylene Glycol 3350 Without Electrolytes and Milk of Magnesia for Children With Constipation and Fecal Incontinence. Pediatrics 2006;118;528-535

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To go to the top of the Constipation Remedy page, click here

To read about how to adjust laxative doses, click here

To view how normal poop/poo should look, click here

To go to the main Constipation page, click here

To return to the Home page, click here


Last reviewed 3 June 2010

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Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.



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