Rajindrajith S, Hathagoda W, Balakrishnan K, Devanarayana NM. Pharmacological management of childhood constipation: Bridging today’s gaps with tomorrow’s therapies. World J Clin Pediatr 2026; 15(1): 113925 [DOI: 10.5409/wjcp.v15.i1.113925]
Corresponding Author of This Article
Niranga Manjuri Devanarayana, Professor, Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Sri Lanka. niranga@kln.ac.lk
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shaman Rajindrajith, Wathsala Hathagoda, Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka
Shaman Rajindrajith, Wathsala Hathagoda, University Paediatric Unit, Lady Ridgeway Hospital for Children, Colombo 00800, Sri Lanka
Keshawadhana Balakrishnan, Division of Pediatric Gastroenterology, Texas Children's Hospital, Houston, TX 77030, United States
Niranga Manjuri Devanarayana, Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama 11010, Sri Lanka
Author contributions: Rajindrajith S conceptualized the paper and drafted the initial manuscript; Hathagoda W, Devanarayana NM and Balakrishnan K were substantially involved in revising it. All authors checked the final manuscript before submission.
Supported by The University of Kelaniya, Research Council, No. RC/2025/PPRP04.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Corresponding author: Niranga Manjuri Devanarayana, Professor, Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Sri Lanka. niranga@kln.ac.lk
Received: September 7, 2025 Revised: October 27, 2025 Accepted: December 29, 2025 Published online: March 9, 2026 Processing time: 180 Days and 19.2 Hours
Core Tip
Core Tip: Functional constipation ranks among the most common disorders associated with gut-brain interactions in children. Despite the existence of well-documented guidelines featuring structured pharmacological management algorithms, long-term outcomes remain unsatisfactory. To bridge the gap, we must consider the following questions: Why is it necessary to change how we approach childhood constipation? Why have most new pharmacological treatments not proven their effectiveness? What new adjustments are needed in clinical trials related to childhood constipation? What alternative strategies can pediatricians and researchers use to implement novel drugs in children? This review highlights current pharmacological treatments for childhood constipation, including osmotic laxatives, stimulant laxatives, lubricants, and enemas, and aims to bridge the therapeutic gap with novel agents such as prucalopride, lubiprostone, and botulinum toxin. Furthermore, pediatric use of medications emerging in adult studies, such as prosecretory drugs like linaclotide and tenapanor, is discussed.
