Liquid Paraffin Lubricant/stool softener | ||||
12 months-6 yrs: 10-15 mL daily 7-12 yrs: 20 mL daily adults: 40 mL daily ONSET: 1-3 days | · Avoid in children < 6 months, and those with swallowing difficulty or significant gastroesophageal reflux · Traditionally there have been warnings to avoid paraffin-based mixtures for 2 hours before sleep; however aspiration in neurologically normal children (beyond infancy) with normal swallowing is extremely unlikely. · Malabsorption of fat-soluble vitamins is reported very rarely with chronic use | · Liquid Paraffin is a non-absorbable oil which lubricates the stool. It is a colourless, odourless, almost tasteless liquid which is easily camouflaged in many foods, especially ice cream. In liquids it will float and disperse into droplets without changing the taste of the liquid. · Parachoc™ contains 50% liquid paraffin, sweeteners and flavour. Sometimes children find it too sweet. · The dose may be increased above the initial recommendations to get additional effect. Oil leakage from the anus should prompt a reduction in dose. | ||
Lactulose Osmotic stool softener | ||||
10-20ml/day (starting dose) in 1-2 doses Max. 90ml/day ONSET: 1-3 days | · Flatulence, abdominal discomfort common · Hyperglycaemia and electrolyte disturbance both very uncommon | · Mixed with fruit juice, water or milk to improve taste. · Has been used in children from 1 month of age | ||
Macrogol 3350 (Movicol -Half™ sachets) Osmotic stool softener | ||||
One sachet BD on day 1, two BD day 2&3, three BD day 4&5, four BD on day 6&7, titrate until desired result is achieved. For 6-11years olds: up to six sachets BD (refer to PI) ONSET: 1-4 days | · Nausea and vomiting, diarrhoea, abdominal cramps and distension · Electrolyte disturbance very uncommon | · Dissolve the contents of one sachet in 62.5 mL of water then drink. More palatable with cold water (or cordial) · May be taken with or without food · Movicol-Half™ has been used in children from 2 years of age | ||
Sennosides (eg.Senokot™) Gut stimulant | ||||
½- 1 teaspoon of granules/day ONSET 6-12 hours | · Abdominal cramps common | · Can be a useful adjunct to softeners. Senna granules can be eaten or mixed with water, milk or food | ||
*Intended to be used along with Chronic constipation Guideline
Reference:
http://www.rch.org.au/clinicalguide/guideline_index/Suggested_initial_medications_for_children_6_months_with_severe_chronic_constipation/
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