Constipation Clinical Pathway — Emergency Department and Inpatient

Patient Education — Functional Constipation

Teaching Points	Diagnosis of Idiopathic constipation is successfully made by history and physical Treatment is effective, but it takes at least 2 mos to resolve, sometimes longer Have child/family review The Poo in You Continue medication(s) until PCP follow-up Call PCP if concern for side effects Diarrhea is the most common Use calendar to document frequency For toilet-trained children: Toilet sitting after meal, 1 min per age, feet flat on the floor/stool
Age ≤ 6 mos	Review proper formula preparation Recommend pears/prunes or pear/prune juice mixed 1:1 with water Consider glycerin suppository if no bowel movement in 24-48 hrs
Age > 6 mos	Demystification, explanation, and guidance for toilet training and calendar Encourage normal fluid intake and physical activity High-fiber diet, including plenty of fresh fruit and vegetables Continue maintenance treatment for at least 2 mos All symptoms of constipation should be resolved for at least 1 mo before stopping treatment Decrease treatment gradually
Resouces	Constipation: Caring for Your Infant Constipation: How to Care for Your Child After Clean-out for Constipation: How to Care for Your Child Constipation: How to Care for Your Older Child or Teen Giving a Suppository for Constipation How to Give Your Child an Enema Encopresis: How to Care for Your Child Polyethylene Glycol 3350 (PEG 3350) Frequently Asked Questions

If you have questions about any of the clinical pathways or about the process of creating a clinical pathway, please contact us.

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

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Constipation Clinical Pathway — Emergency Department and Inpatient

Patient Education — Functional Constipation

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Constipation — Patient Education — Clinical Pathway: Emergency Department and Inpatient

Constipation Clinical Pathway — Emergency Department and Inpatient

Patient Education — Functional Constipation