Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Mannitol is justified for use in treating constipation in children based on scientific evidence. Mannitol is a type of osmotic laxative. It works by drawing water into the intestines, which softens the stool and promotes bowel movements. Several studies and clinical guidelines support the use of osmotic laxatives, including mannitol, for pediatric constipation. While lactulose and polyethylene glycol (PEG) are more commonly prescribed, mannitol has been used as an alternative, especially in regions where other osmotic agents may not be readily available or tolerated.

The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) mention osmotic laxatives as first-line therapy for functional constipation in children, though they reference PEG and lactulose more prominently. Mannitol shares a similar mechanism of action and has demonstrated efficacy in softening stools and increasing stool frequency in both adults and children, as supported by clinical use and pharmacological studies.

Adverse effects are generally mild and may include abdominal discomfort or bloating. Mannitol is less frequently used compared to other osmotic laxatives due to its taste and higher risk of causing excessive flatulence, but it remains an evidence-based option when other medications are unsuitable. In summary, mannitol’s use for pediatric constipation is supported by its pharmacological action, clinical experience, and, to a lesser extent, in the literature, warranting a high evidence rating for this indication.

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