طفلة عمرها ٥ سنوات تخرج كل ٥ أيام برازاً صلباً مؤلماً، وتختبئ وتحبس البراز، وأحياناً يتسرب براز لين في ملابسها. تشرب ماء قليلاً وتأكل خضاراً قليلة. البطن لين، ولا يوجد قيء أو نقص وزن. ما الخطة الأنسب؟

A 5-year-old girl passes hard painful stools every 5 days, hides and withholds stool, and sometimes leaks soft stool into her underwear. She drinks little water and eats few vegetables. Abdomen soft, no vomiting or weight loss. What is the best plan?

1. Stopping all dietary fibre because the stool is sometimes soft
2. A strong daily purgative without any toilet schedule
3. A safe laxative, toilet sitting after meals, water and fibre
4. Punishing her for soiling so she learns control

Answer: C) A safe laxative, toilet sitting after meals, water and fibre. Functional constipation in children is treated with a safe laxative, post-meal toilet sitting, fluids and fibre, and no punishment; soiling is overflow, not defiance.