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Functional constipation – behavioural — RACP Paediatrics MCQ

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ModerateGIFunctional constipation – behaviouralRACP Paediatrics

A 3-year-old has functional constipation with overflow soiling (encopresis) despite 6 months of macrogol at adequate doses with good adherence. The parents are frustrated and the child is socially isolated at preschool. What additional management strategy is most important?

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Correct answer: E — Functional constipation (Rome IV)

Functional constipation with encopresis requires a comprehensive approach beyond laxatives: behavioural strategies (regular toilet sitting after meals for 5-10 minutes using a timer and reward chart), education/demystification (explaining overflow soiling is involuntary, not deliberate), dietary advice, and ongoing follow-up. Psychological support may be beneficial. Treatment duration is typically months to years.

Reference: RCH Melbourne – 2023 – Constipation CPG; RACP Paediatric Curriculum – GI