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Functional constipation — RACP Paediatrics MCQ

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EasyGastroenterologyFunctional constipationRACP Paediatrics

A 4-year-old has painful hard stools every 5 to 7 days and faecal soiling. Growth is normal, neurological examination is normal and symptoms began after a painful fissure. What is the most appropriate management?

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Correct answer: E — Polyethylene glycol disimpaction followed by maintenance therapy and toileting plan

Functional constipation with overflow soiling requires disimpaction, maintenance laxative therapy and behavioural toileting support. Fibre advice alone is usually insufficient when impaction and soiling are present. The pearl is that overflow soiling is often misinterpreted as diarrhoea, but treatment requires clearing retained stool.

Reference: RCH Clinical Practice Guidelines: Constipation; Therapeutic Guidelines (eTG)