Osmotic laxatives are the standard treatment for pediatric constipation, with stimulant laxatives used only as a last resort. Despite its frequent usage in adult and pediatric constipation, there is little evidence on the regular and long-term use of bisacodyl in the pediatric population. Retrospective analysis of patients referred to a tertiary care children’s hospital with functional constipation who had not responded to standard treatment. Patients had a BM frequency of 2 per week and were treated with bisacodyl on a regular basis for more than 4 weeks. Demographic factors, bisacodyl dose and duration of treatment, number of BM/week before and after treatment, adverse effects, and length of follow-up were all documented. When the frequency of BM rose from baseline to 3 BM/wk, the response to treatment was effective. A total of 164 patients were enrolled in the study, with 52 percent of them being female and a median age of 9.45 years. The median dose of bisacodyl was 5 mg/day, and the typical length of therapy was 14 months, with 90 percent of patients taking the drug for 36 months. After starting bisacodyl, the median number of BM/wk increased from 2 to 4 bm/wk. Approximately 57 percent of patients responded well. At the end of the study, 55 percent of patients had successfully weaned off bisacodyl.

Bisacodyl is an effective and well-tolerated long-term treatment for children of functional constipation that has not responded to conventional therapy. The majority of patients who had a positive reaction were effectively weaned off the drug.

Reference: https://journals.lww.com/jpgn/Abstract/2020/09000/Long_term_Use_of_Bisacodyl_in_Pediatric_Functional.2.aspx