A 4-year-old boy has constipation with painful hard stools and stool withholding. He has normal growth, no delayed meconium history, no neurologic

Question

A 4-year-old boy has constipation with painful hard stools and stool withholding. He has normal growth, no delayed meconium history, no neurologic deficits, and no abdominal distention. Which of the following is the most appropriate next step in management?

Accepted Answer

Polyethylene glycol and behavioral toileting plan

Answer

Immediate rectal biopsy

Answer

Emergency colectomy

Answer

Long-term opioid therapy

Answer

Gluten-free diet without testing

Functional constipation — USMLE Step 3 MCQ

A 4-year-old boy has constipation with painful hard stools and stool withholding. He has normal growth, no delayed meconium history, no neurologic deficits, and no abdominal distention. Which of the following is the most appropriate next step in management?