A 3-year-old child has had hard stools and pain on defecation for months. Which laxative does NICE recommend first line?
Answer and explanation
Correct answer: C. Macrogol with disimpaction if impacted
- Step 1: Constipation in children is treated promptly to avoid retentive behaviour.
- Step 2: Polyethylene glycol (macrogol) is first-line, with stimulant laxatives added if needed.
Answer
Macrogol with disimpaction if impacted.
Why not the others: Increased dietary fibre alone, without any laxative being prescribed: Fibre alone is not enough. Long-term daily phosphate enemas given by the parents at home: Enemas are not routine. Senna as the only first-line agent, with no disimpaction at any stage: Stimulant laxatives are added if macrogol fails.
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