Patrick is a 10-year old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. The most appropriate choice of medication for a 10-year old child would be:

A. PEG 3350 (Miralax): PEG 3350 is an osmotic laxative commonly used for chronic constipation in children. It works by drawing water into the colon to soften stools, but its onset of action is gradual, typically 12–72 hours, making it less suitable for rapid relief in acute cases. B. Bisacodyl (Dulcolax) suppository: Bisacodyl is a stimulant laxative that acts directly on the colonic nerves to increase peristalsis and promote bowel evacuation. Rectal administration via suppository provides rapid onset, usually within 15–60 minutes, making it ideal for a child needing more immediate relief of constipation. C. Docusate (Colace) suppository: Docusate is a stool softener that facilitates water penetration into the stool. It is gentle and effective for preventing constipation, but it acts slowly and does not provide rapid relief, especially in cases of acute discomfort, limiting its appropriateness for Patrick’s current symptoms. D. Polyethylene glycol electrolyte solution: Polyethylene glycol with electrolytes is used primarily for bowel cleansing before procedures or in severe constipation. It is effective but often requires large fluid volumes, which can be difficult for children to tolerate, and is more intensive than needed for routine acute constipation management.