Poop, part 2

soap suds enema seems to work best for me. I'm not a fan of Enemeez®....let the nurse do the rest. You don't have the time to be picking away at the bedrock of stool when you have all these other patients that require your attention.

Pediatric constipation:

It happens, more often than not it isn't Hirschsprungs.

I. do a rectal temp, sometimes that's all you need
II. stick your pinky in there to confirm the stool is soft.
III. sorbitol-containing stuff
   A. Sorbitol 1-3mg/kg/day
   B. Lactulose
   C. prunes, peaches, pears, etc.
IV. Glycerin suppositories
V. Osmotic laxatives

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN). (2006). Clinical Practice Guideline: Evaluation and Treatment of Constipation in Infant and Children: Recommendations of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition. Journal of Pediatric Gastroenterology 43:e1-e13.

References:
Cline, DM, Ma, OJ, Cydulka, RK, Meckler, GD, Handel, DA, & Thomas, SH (2012). Tintinalli's Emergency Medicine Manual (7th ed.) McGraw Hill Professional: Columbus, OH.

Ferry, GD. Treatment of Chronic Functional Constipation and Fecal Incontinence in Infants and Children. In: UpToDate, Basow, DS (Ed), UpToDate,Waltham, MA, 2012.

Ferry, GD. Prevention and  Treatment of Acute Constipation in Infants and Children. In: UpToDate, Basow, DS (Ed), UpToDate,Waltham, MA, 2012.

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN). (2006). Clinical Practice Guideline: Evaluation and Treatment of Constipation in Infant and Children: Recommendations of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition. Journal of Pediatric Gastroenterology 43:e1-e13.