CONSTIPATION

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Oral Disimpaction

Mineral Oil

15-30 mL for every yr of age, to 240 ml/may be given in 2 divided doses

Polyethylene glycol-electrolyte solution

25 ml/kg/hr(to 1000 ml/hr)

by NG tube until clear

or 20 ml/kg/hr for 4 hours

Magnesium hydroxide

(milk of magnesia)

1-3 ml/kg/d of 400mg/5ml in 2 divided doses

(30-60ml/70 kg adult)

Palatability is poor, risk of hypermagnesemia particularly if in renal failure

Magnesium citrate

(citrate of magnesia)

<6yr: 1-3ml/kg/d

6-12 yr:100-150 ml/d

>12yr:150-300 ml/d

(all in single dose or 2 divided doses)

Maintenance

Mineral oil

1-3 ml/kg/day in a single dose or 2 divided doses

Polyethyline glycol 3350

(Miralax)

8.5-34 g/d (start at 0.8 g/kg)

Miralax (17g)= 1 tablespoon of MiraLax powder, add to 8 ounces of water, juice, soda, coffee or tea.
(expect results in second week)

Magnesium hydroxide

(milk of magnesia)

1-3 ml/kg/day of 400 mg/5ml

in 2 divided doses

Lactulose(Duphalac)

1-3 ml/kg/d in 2 divided doses

(sweet, can be diluted, cause flatulance and abdominal cramping, diaper rash is a common problem, fermentation of bacteria causes acidic stools)

Docusate

Not effective for ordinary therapy

Rectal  Disimpaction