How Long Are Laxatives Used For?

The duration of laxative treatment for childhood constipation can vary greatly from child to child, but it is almost always a long-term process. It is a common misconception that laxatives should only be used for a few days. For chronic constipation, treatment often lasts for several months, and sometimes even years.

The Goal of Long-Term Treatment

The primary goal of maintenance therapy with laxatives is to prevent the recurrence of fecal impaction and to allow the stretched rectum and colon to return to their normal size and function. This takes time. If treatment is stopped too early, before the bowel has fully recovered and before the child has established regular, pain-free bowel habits, relapse is very likely.

The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guidelines state that laxative therapy should be continued for at least two months, and that the dose should be tapered gradually only after the child has been symptom-free for at least one month [1].

Weaning Off Laxatives

The process of stopping laxatives should be slow and methodical, and always done in consultation with a healthcare provider. The dose is typically reduced very gradually over a period of weeks or months. During this time, it is crucial to continue to encourage a high-fiber diet, adequate fluid intake, and regular toilet sitting to help the child maintain soft, regular stools without the help of medication.

Some children may be able to stop laxatives completely, while others may need to remain on a small maintenance dose for a longer period to prevent relapse. The long-term prognosis for childhood constipation shows that about 50% of children are recovered after 6 to 12 months of treatment, but many require longer therapy [2].