Patient discussions
Dietary changes, particularly increased intake of fluids and nonabsorbable carbohydrates or dietary fiber, should be recommended. Increase in physical activity may be suggested for older children. The anxiety of both parent and child should be addressed. The child may be fearful of painful defecation, and parents need to understand that forcing toilet training in this situation will be ineffective. In older children, fecal incontinence and its social consequences need a nonaccusatory, sympathetic management approach. It may be necessary to repeat the education several times during treatment.
If treatment for impaction is required, parents should be advised about what to expect, including elimination of the impacted stools and potentially a period of diarrhea.[4] This is important to prevent parents from stopping the disimpaction prematurely.[4]
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