Aim: The purpose of this study was to describe and evaluate the effectiveness of a six-month structured bowel management programme (SBMP) for children with therapy-resistant functional constipation (FC). Method: A retrospective review of medical records with a pre-post design was conducted at an outpatient paediatric clinic in Sweden. Bowel frequency, stool form, faecal incontinence, and abdominal pain were compared before and after the intervention. Predictive factors for successful discharge and duration of care through long-term follow-up were calculated. Results: Of the 142 children enrolled in the SBMP, 132 completed the programme. Despite previous FC therapy resistance, the SBMP achieved a treatment success rate of 44 % within 6 months, and 58 % after 12 months. The need for additional contacts beyond those scheduled and persistent faecal leakage were significant predictors of non-recovery. Long-term follow-ups indicate that after 2 years of care, approximately 80 % of the children achieved recovery. Conclusion: This study highlights the effectiveness of the SBMP in managing therapy-resistant FC in children at a general outpatient paediatric clinic, while also emphasising the necessity of long-term follow-up for sustainable results. Implications to practice: The results suggest that a structured care programme like the SBMP helps set realistic expectations and ensures consistent quality of care for children with FC, despite the severity and complexities involved. (c) 2025 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

Childhood functional constipation (FC) is a worldwide problem with treatment regiments affecting everyday life.

Aim

To explore parents´ experiences of living with a child with FC and its impact on everyday family life.

Method

A qualitative phenomenological interview study using a reflective lifeworld research approach. Interviews with 15 parents of otherwise healthy children aged 1–14 years affected by FC.

Findings

Shame is the driving force making parents put everyday life on hold. The quest for control, self-imposed loneliness, guilt, inadequacy, and frustrating battles become essential parts of everyday life to protect it from FC-related shame.

Conclusion

FC has as great an impact on everyday life as any childhood illness. Every part of family life is affected by FC. Continuously family support and guidance are needed.

Practice implications

Healthcare professionals need to take FC more seriously, listen to the parents and try to understand their experiences of everyday life to enable custom made care plans with the family-unit in focus. Care with clinical sensitivity might help parents deal with the attendant shame and stigmatization that stem from illness beliefs about FC.

Aim

The aim was to explore the lived experiences of parents who give oral and rectal pharmacological treatment to their children with functional constipation at home.

Design

A phenomenological design with a reflective lifeworld research approach that describes phenomena as they are experienced by individuals.

Methods

From January–May 2019, 15 interviews were conducted with parents of children with functional constipation with home‐based oral and rectal treatment. Parents were recruited from three different healthcare levels. Open‐ended questions were used starting from the description of a normal day with constipation treatment. Analyses were made with an open and reflective ‘bridling’ attitude.

Findings

Constipation treatment causes parents to question their parental identity and what it means to be a good parent. Forced treatment makes them feel abusive and acting against their will as parents. There is a conflict between doubt and second thoughts about the treatment, the urge to treat based on the child's needs and encouragement from healthcare professionals to give treatment.

Conclusion

As pharmacological constipation treatment can be experienced as challenging, it is important to help parents make an informed decision about how such treatment should be carried out at home. The findings reveal a medical treatment situation where parents hesitate and children resist, resulting in insecure parents who question their parental identity.

Impact

The findings point to the importance of supporting parents in treatment situations. Healthcare providers need to treat children with constipation with greater focus and more prompt management to prevent these families from lingering longer than necessary in the healthcare system.

Background

Childhood functional constipation, a common concern within child healthcare, necessitates oral and rectal medical treatments, that are mostly administered by parents in the home environment. It is important to gather children’s perspectives in child- and family-centred care. The private nature of toileting, bowel movements, and faecal incontinence are areas of taboo and stigmatisation. Research is scarce on how children perceive this common but private situation of oral and rectal constipation treatment.

Objective

To explore children’s experiences of functional constipation and its treatments.

Design

A qualitative interview study with a constructionist epistemology and a predominantly experiential orientation.

Setting

Individual interviews were conducted in the child’s home, in the child’s familiar outpatient clinic, or on university premises. Open and permissive conversations about bowel habits, constipation, medical treatments, faecal leakage, and related feelings were digitally recorded and transcribed.

Participants

Twenty children (thirteen boys and seven girls) with functional constipation, aged 6–14 years, from four different outpatient clinics in southeast Sweden, who had experiences of oral and rectal medical treatments, were purposively recruited. Exclusion criteria were anorectal malformation or prior rectal surgery.

Methods

Transcripts were analysed using reflexive thematic analysis by Braun & Clarke.

Findings

This study provides a deeper understanding of why children choose not to go to the toilet. It explains how children perceive constipation treatment as simultaneously good and bad, and describes how faecal incontinence is strongly associated with the fear of exposure. The study also outlines the hopes and prospects of a cure. Four themes were created: 1) Procrastinating toilet visits – focus elsewhere, 2) Dreading exposure in a vulnerable position, 3) Enemas, a nightmare and a relief, 4) A doubtful hope during the treatment journey.

Conclusions

Care providers must acknowledge and validate the child’s perspective in constipation treatment situations. Our study provides an understanding of this perspective, which should be incorporated into clinical conversations with children about their diagnosis and proposed constipation treatment regimen. Adopting an approach that acknowledges children’s views based on this new information may enhance collaboration between care providers, parents, and children during constipation care.