Medications

There are a wide range of medications available both over the counter and by prescription from a medical practitioner. Simplistically, these can be broken into two groups - stool softeners or stimulants.

The stool softeners that are most commonly used these days are Movicol and Osmolax. Other brands include Parachoc, Actilax, and Coloxyl. The stimulant laxatives that are available over the counter at pharmacies include Dulcolax and Senna products.

In my experience, many children who have a history of constipation, soiling, or anxiety about pooing in the toilet (especially during the toilet training stages) are commonly advised to use a stool softener first. This can cause more problems for children who are anxious or stubborn, because they often try to withhold their stools which results in more frequent soiling.

The stimulant laxatives can often be a more effective approach. Firstly, there is usually a time frame involved which allows children to have the opportunity to poo in the toilet at home after a busy day at school or daycare. Secondly, it also enhances the signs that a poo is imminent, which allows parents and carers to direct the child to the toilet more successfully.

All laxatives will have a softening/loosening effect which is benefical for two reasons - behaviourally it makes it more difficult for the child to “hold on”. Physically, the laxatives help the bowel return to a more normal size if it has become distended from constipation or withholding stools.

There are many misconceptions about laxatives, and labelling on packages seems to be just as frightening to many parents. I have also become aware of the support groups that are easily accessed by parents on online forums that provide other parents with their own advise based on their own experiences. This is not advisable and very misleading. Health chat lines are also often very unhelpful as the advisors are never fully aware of the holistic nature of a child’s problems.

I strongly encourage parents to discuss the appropriate dosage and choice of laxative with your GP, Paediatrician, or gastroenterologist. The right administration of the right laxative is essential to overcoming constipation, soiling, encopresis, and often toilet training issues as well.