Constipation in children and young people: diagnosis and management

National Institute for Health and Care Excellence

Diet and lifestyle

Do not use dietary interventions alone as first-line treatment

  • Treat constipation with laxatives and a combination of:
    • negotiated and non-punitive behavioural interventions suited to the child or young person’s stage of development. This could include scheduled toileting and support to establish a regular bowel habit, maintenance and discussion of a bowel diary, information on constipation, and use of encouragement and rewards systems
    • dietary modifications to ensure a balanced diet and sufficient fluids are consumed
  • Advise parents and children or young people (if appropriate) that a balanced diet should include:
    • adequate fluid intake
    • adequate fibre. Recommend including foods with a high fibre content (such as fruit, vegetables, high–fibre bread, baked beans and wholegrain breakfast cereals) (not applicable to exclusively breastfed infants). Do not recommend unprocessed bran, which can cause bloating and flatulence and reduce the absorption of micronutrients
  • Give written information about diet and fluid intake to children and young people and their families
  • Start a cows’ milk exclusion diet only on the advice of the relevant specialist services
  • Advise daily physical activity that is tailored to the child or young person’s stage of development and individual ability as part of ongoing maintenance

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