Osmotic and stimulant laxatives for the management of childhood constipation

Functional constipation is a common condition in children worldwide, affecting approximately 9.5% of the pediatric population. It is characterized by symptoms such as infrequent or painful bowel movements, stool withholding, and fecal incontinence. The condition is associated with a diet low in fruits and vegetables, reduced physical activity, and can significantly impact a child's quality of life. Diagnosis of functional constipation is based on Rome IV criteria, which distinguish between children up to four years of age and older children. Treatment includes both pharmacological and non-pharmacological approaches, with osmotic laxatives (such as lactulose and polyethylene glycol) and stimulant laxatives (such as senna and bisacodyl) forming the main part of medical therapy. Successful treatment requires a combination of pharmacological interventions with behavioral, educational, and dietary measures.