Constipation: Surprising truths and tips for relief

Constipation is an extremely common childhood condition. One I deal with almost on a daily basis in clinic and one that can be surprisingly hard to get control of.

Parents are often at a loss on what to do about something that is causing their child significant discomfort, but also something they feel should be relatively easy to treat.

The trick is to always be one step ahead of constipation when it comes to your child.

Here are some surprising truths about constipation:

• It can really hurt and be a source of significant, recurrent abdominal pain. After a thorough history and physcial exam (sometimes even an x-ray, depending on the situation), parents are shocked to find out, that, yes excess and blocked stool is the culprit for the tears and complaints of pain.

• A child can be constipated in spite of reported daily bowel movements. Often, parents will discount constipation as a cause of their child’s stomach pains because the child will report having a somewhat “normal” bowel movement. However, if the stools are small, hard, and difficult to pass; this could be a sign that your child is not completely emptying his bowels. Having abnormally large and infrequent stools is another sign of constipation. In both instances, stools are typically hard to pass and the child may start withholding which will only worsen the condition.
• On the flipside, your child may only have bowel movements every 2-3 days and not be constipated. The defining features are not necessarily based on frequency but more on symptoms such as abdominal pain, hard and difficult to pass stools, blood streaked stools, or a fear of going to the bathroom due to the anticipated pain.

When children are most prone to it:

• Transitioning to solid foods and whole milk.
• Potty training
• School entry

Stay one step ahead with these tips:

• Make your child’s daily meals full of fiber rich foods. Think whole fruits, whole grains, fiber cereals, and green/leafy vegetables.
• Water, water, and more water. Keep a refillable water bottle on hand and encourage your child to drink frequently.
• Moderate milk intake. Too much of a good thing can be bad for your child’s digestion. Instead of filling up on fiber rich foods, she is filling up on this. After the age of 1, 16 ounces per day is more than enough.
• Make a smoothie: if you have a picky eater…have her drink her fiber. Add whole fruits, some skim milk, yogurt, and a splash of juice.
• Try a daily “P” juice (prune or pear) for breakfast to get things back on track.
• A daily fiber supplement can help fill in the fiber gap.
• Exercise. Get your kids outside (or inside) and moving for a good hour per day.

Laxatives

Sometimes, your child just needs a laxative to get back on track. Discuss this possibility with your child’s pediatrician. Once the cycle of constipation has set in, dietary changes alone may not turn it around. Be sure to adhere to the plan outlined with your pediatrician and continue with the constipation fighting foods above.

A word about encopresis

If your child starts to leak stool involuntarily or is having stool accidents, this is a sign that constipation has led to withholding which has led to a disruption of normal rectal tone and now things are really bad. Time for a more serious intervention and one that likely involves the help of a pediatric gastroenterologist.

Conditions associated with constipation:

• Bedwetting: Study revealed that treating children for constipation (even when not obvious through history taking), resulted in resolution of bedwetting.

• UTIs: chronic and untreated constipation can put your child at increased risk for bladder infections.

So, although constipation is common, it can really wreak havoc on the quality of life for little ones if we don’t stay one step ahead. Get that fiber in them, encourage water intake, get them up and running, and never hesitate to ask your child’s healthcare provider for advice or assistance.

What questions do you have about constipation and your child? Any good constipation fighting tips to share?