What are the potential side effects of common laxatives used in children, and how can I mitigate them?

Potential side effects of commonly used laxatives in children include:

• Hard stools or stool withholding if laxatives are not used appropriately, which can lead to re-impaction or worsening constipation ¹.
• Abdominal pain and bloating, especially initially during disimpaction treatment ².
• Increased symptoms of soiling during disimpaction, which may be temporary ².
• Adverse effects specific to certain laxatives, such as electrolyte imbalance with electrolyte-containing macrogols, though these are generally well tolerated ¹.

Strategies to mitigate these side effects include:

• Gradually reducing the dose of laxatives over months once regular bowel habits are established to prevent re-impaction and maintain stool consistency ¹.
• Ensuring adherence to prescribed regimens and regular follow-up to monitor response and side effects ¹.
• Using the Bristol Stool Form Scale to assess stool consistency and adjust treatment accordingly ¹.
• Providing tailored dietary advice to ensure adequate fluid and fibre intake, which can help reduce gastrointestinal discomfort and improve stool consistency ¹.
• Starting treatment early to prevent long-term complications and avoid abrupt cessation of laxatives, which can cause relapse ¹.