Oral versus rectal laxatives for functional constipation in child

Main Article Content

Wiji Joko Pranoto
Supriatmo Supriatmo
Melda Deliana
Atan Baas Sinuhaji


Background Functional constipation is a common childhood condition. Benefits of oral and rectal laxatives in terms of recovery and recurrence in children with functional constipation are still controversial.
Objective To compare the effectiveness of oral and rectal laxatives in terms of recovery and recurrence in children with functional constipation.
Methods Children aged 8 to 17 years who met the Rome III criteria for functional constipation were enrolled in this open randomised trial. Data was collected through questionnaires, interviews, and physical examinations. The participants were randomly assigned to receive stimulant laxatives (5 mg bisacodyl) either orally for three consecutive days or rectally in a single dose. Subjects kept daily defecation records for 7 days, and were followed up on days 14, 21, 28, 35, and 42. Comparisons of defecation patterns and recurrence of constipation between groups were assessed using Chi-square test.
Results Of 99 subjects, 46 children (5 boys, 41 girls) received oral laxatives (group I) and 45 children (8 boys, 37 girls) received rectal laxatives (group II). Four children in each group dropped out. Baseline characteristics are comparable between the groups. Rate of recovery in the first 7 days was higher in the oral compared to rectal groups [84.8% versus 73.3%, respectively, but this was not statistically sininficant (P=0.278)]. In the second week, the recurrence of constipation was significantly higher in the rectal (57.5%) than in the oral laxative group (42.5%) (P=0.026).
Conclusion Although recovery tends to occur more with oral compared to rectal laxative agents, the difference was not statistically significant. Higher recurrence in the second week after treatment occurred with rectal laxative agent. [Paediatr Indones. 2016;56:162-6.].

Article Details

How to Cite
Pranoto W, Supriatmo S, Deliana M, Sinuhaji A. Oral versus rectal laxatives for functional constipation in child. PI [Internet]. 1Jul.2016 [cited 16Oct.2019];56(3):162-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/231
Pediatric Gastrohepatology
Received 2016-08-18
Accepted 2016-08-18
Published 2016-07-01


1. Jufrie M, Soenarto YS, Oswari H, Arief S, Rosalina I, Mulyani SN. Gastroenterologi-Hepatologi. 2nd ed. Jakarta: Badan Penerbit IDAI; 2011. p. 201-13.
2. Prasetyo D. Konstipasi pada anak. In: Sinuhaji AB, Lubis M, Supriatmo, Nafianti S, Lubis BM, editors. From basic to community. Medan: Badan Koordinasi Gastroenterologi Indonesia (BKGAI); 2010. p. 55-63.
3. Brennan LK. Constipation. In: Zaotis LB, Chiang ZW, editors. Comprehensive pediatric hospital medicine. Philadelphia: Mosby Elsevier; 2007. p. 612-6.
4. Bongers ME, Benninga MA, Maurice-Stam H, Grootenhuis MA. Health-related quality of life in young adults with symptoms of constipation continuing from childhood into adulthood. Health Qual Life Outcomes. 2009;7:20. doi: 10.1186/1477-7525-7-20.
5. Biggs WS, Dery WH. Evaluation and treatment of constipation in infants and children. Am Fam Physician. 2006;73:469-77.
6. Bongers ME, van den Berg MM, Reitsma JB, Voskuijl WP, Benninga MA. A randomized controlled trial of enemas in combination with oral laxative therapy for children with chronic constipation. Clin Gastroenterol Hepatol. 2009;7:1069-74.
7. Coughlin EC. Assessment and management of pediatric constipation in primary care. Pediatr Nurs. 2003;29:296-301.
8. Wyllie R. Constipation. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: Saunders Elsevier; 2007; p. 1525-65.
9. Loening-Baucke V. Prevalence rates for constipation and faecal and urinary incontinence. Arch Dis Child. 2007;92:486-9.
10. Saps M, Sztainberg M, Di Lorenzo C. A prospective community-based study of gastroenterological symptoms in school-age children. J Pediatr Gastroenterol Nutr. 2006;43:477-82.
11. McGrath ML, Mellon MW, Murphy L. Empirically supported treatments in pediatric psychology: constipation and encopresis. J Pediatr Psychol. 2000;25:225-54.
12. Bekkali NL, van den Berg MM, Dijkgraaf MG, van Wijk MP, Bonges ME, Liem O, et al. Rectal fecal impaction treatment in childhood constipation: enemas versus high doses oral PEG. Pediatrics. 2009;124:1108-15.
13. Altman DV. Obat yang digunakan dalam penyakit gastrointestinal. In: Bagian farmakologi FK UNAIR. Farmakologi dasar dan klinik. Jakarta: Salemba Medika; 2004. p. 541-64.
14. Manabe N, Cremonini F, Camilleri M, Sandborn WJ, Burton DD. Effects of bisacodyl on ascending colon emptying and overall colonic transit in healthy volunteers. Aliment Pharmacol Ther. 2009;30:930-6.
15. Staiano A, Andreotti MR, Greco L, Basile P, Auricchio S. Long-term follow-up of children with chronic idiopathic constipation. Dig Dis Sci. 1994;39:561-4.
16. Sutphen JL, Borowitz SM, Hutchison RL, Cox DJ. Long-term follow-up of medically treated childhood constipation. Clin Pediatr. 1995;34:576-80.
17. van Ginkel R, Reitsma JB, Buller HA, van Wijk MP, Taminiau JA, Benninga MA. Childhood constipation: longitudinal follow-up beyond puberty. Gastroenterology. 2003;125:357-63