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학습 자료 둘러보기 →The first step is colonic disimpaction, often with oral osmotic agents like polyethylene glycol, to clear the hard stool mass. This must be paired with behavioral strategies.
Implement a regular toileting schedule. Have the child sit on the toilet for 5-10 minutes after meals to leverage the gastrocolic reflex. Use a footstool for proper positioning.
Use positive reinforcement consistently. Reward the act of sitting with praise or a sticker chart. Never punish for soiling accidents, as this increases anxiety and stool withholding.
Avoid stimulant laxatives as first-line maintenance. Ensure adequate fluid and fiber intake. A non-punitive, supportive environment is critical for breaking the cycle of shame and retention.
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