Constipation among Children

Constipation is very common in children of all ages. Of all visits to the pediatrician, 3% are in some way  related to this complaint .25 percent of visits to a pediatric gastroenterologist are due to constipation.

Millions of prescriptions are written every year for laxatives and stool softeners.

What Causes Constipation?

Constipation is mostly functional. This means it is not due to any medication or anatomic abnormalities .Ninety percent of the causes of constipation come under this category

.

· Immature system: In some infants, constipation can be due to an immature system,improper relaxation of the rectal muscles.

· Some breast fed infants can go without a bowel movement for several days. However it is important to look for signs such as

 Distension of the tummy

  Persistent vomiting especially

 Inconsolable crying

If any of these are seen then it is important to contact your primary care provider or visit the emergency room. It is important to rule out obstruction of the intestines, ileus, Mal-rotation, Volvulus.

 

 Fiber: Lack of fiber can also cause constipation later on in life. Once the child has been constipated for more than a few days, the retained stool can fill up the Large intestine (the colon) and cause it to stretch. This overstretched intestine then does not work efficiently to expel stool.

 
Then constipation becomes a behavioral issue. The bowel movements are hard and painful .Most of the times children withhold their stools due to fear of pain. (Withholding Behavior)

In some children, constipation can begin when

· there are changes in the diet

· the time of toilet training

 Following travel, or after a viral illness.

· Older children can begin withholding the stool .Even if they have an urge to use the bathroom. They may be afraid to use public toilets. School or summer camps, with facilities that are not so clean, are common causes of stool withholding in this age group.

There are some causes that may be due to a problem with the muscles of the stomach, anatomic abnormalities, endocrine problems, drugs. These causes are not so common.

Hence it become extremely important to talk to you primary care provider with regard to the consistency of the stools, when and at what age did your child start having hard stools. It is also important to know if your child had difficulty passing the first stool. This may not be functional and may need to be further looked into.

When does constipation become a problem?

 

· If your child has Hard painful stools that are difficult to pass

· If your child consistently skips days without having normal

  Bowel movements

· If your child has symptoms such as constipation stomach pain, poor appetite, and  crankiness

· If you see bright blood in the stool or on the toilet paper after wiping. This hard stool can tear the lining of the anus which is also called a fissure. These fissures are very painful and bleed.

· If your child has Problems with passing the stool in the underclothes. Most of the times  the child is not aware of this soiling. The child does not feel the urge to have a bowel movement and has an accident. These stool accidents are often mistaken as diarrhea.

· Pain-abdominal or rectal

· Daytime or night time urinary incontinence and recurrent attacks of a urinary tract infection

In most cases there is no need for testing prior to treatment for constipation. However sometimes the doctor may need to do an X-ray of the tummy or perform other tests to asses the degree of stool or rule out other causes of constipation.

How do you treat constipation?

The goal of treatment is soft, regular stools. Positive results requires time and patience

Diet rich in fiber and fluids are important in the treatment of constipation. Fiber such as fruits, vegetables, whole grain breads, cereals.

Many a time’s behavior modification becomes extremely important. It is often helpful to start a bowel training routine where the child sits on the toilet for 5 – 10 minutes after every meal or before the evening bath. It is important to do this consistently in order to encourage good behavior habits. After every successful bowel movement a reward such as a sticker may be given that reinforced this positive behavior.

A few children may require an initial “clean-out” to help empty the colon of the large amount of stool. This typically entails the use of laxatives by mouth or even suppositories or enemas for a short period of time.

Please feel free to post any comments or questions

Comments

[pwt]

Hie My child is five years old and has red blood in her poop. She suffers from severe constipation . What should i do?She cries and cries when she has abowel movement.

[pwt]

Dear Naina
I would like to ask you a few more questions. Is the blood bright red in color. Is it mixed with stool? Is it just on the toilet paper when you wipe?
How hard are the stools?
Bright red blood in a five year old with so much pain while having a bowel movement is usually due to a fissure.
A fissure is a break in the inner linning of the anus. It is usually due to hard stools. Children experince a lot of pain while passing stool.More than 90% of children with blood in their stools have an anal fissure.
Your primary care provider should do a rectal examination. He should be able to see a fissure.
He may advise sitz baths and stool softners.
I would advise you get an appointment with him.
The other causes of bright red blood in the stool could be :
Polyps
angio dysplasias
meckels diverticulum-which is usually painless
Gastro-entritis
Inflammatory bowel disease like crohns and collitis: It is very low in my differnetial. children usually have diahrrea. There is alot of abdomianl pain.
the blood is mixed with stool.
Hope this helps.
Please feel free to ask me any more questions.
However i would advise you see your primary care provider.

[ranjani]

my child is 1year and 6months and he passes hard stools with a trace of blood.but he does not cry or have any pain at that time.Please give your suggestion for helping me to tackle his constipation

[ranjani]

my child is 1year and 6months and he passes hard stools with a trace of blood.but he does not cry or have any pain at that time.Please give your suggestion for helping me to tackle his constipation

[bloodinstool]

Hi

Thanks for the lovely posts- It was very enlightning and educative. Now i know what signs to look out for just incase my kids are going through any of these traumers and better still how to resolve it.

Keep posting ...

love u loads

regards

[Hemorrhoid]

Was also very curious if there are natural rememdies to blood in stool besides visiting general practitioner?

Thanks

[Nicola]

Excellent post! Really well researched and informative.

I found that cheese made the situation far worse which is a shame as I loved eating cheese

It’s still a small price to pay for being pain free

Well done and keep up the good work.

Nicola.

[HemorrhoidRAGE]

I've seen a few natural constipation treatments out there, but I'm afraid to use them on my child.

I just don't feel comfortable using something that doesn't have proven studies backing it.

[m mathur]

my neice is 2yrs old and is suffering with constipation.we give her oats,rice pulses ,fruits milk.she doesn't chew her food,so we give her semi-solids or mashed food,which she just gulps.she is a very active and alert child.her mother has hypothyroid,is there a possibility that she(baby) has thyroid problem.she doesn't show any symptoms except frequent constipation.

[Barbara Thomson]

Helpful post. I especially found it informative expecially for cases of cosntipation among children and infants. Thank you so much for sharing, Barbara.

[Ugg Classic Short]

Just exhibits that writing via encounter brings so a lot of depth and relevance to ones readers. Thank you for sharing.

[Hemorrhoid Treatment]

Great post! It's beneficial not only to children but to adults as well.

[crunches]

My younger brothers are addicted to cheese. My father has secretly been putting fiber in their drinks.

[Constipation remedies]

Thanks, I always advocate on my website, that people get enough fiber in there diets, it just makes things go "smoother"

[viagra online]

And you base your "this is dangerous" statement on what, exactly? Medical or scientific proof? Or your own unfounded fears and ignorance? As far as I am aware, there has not been a single instance of a tourist getting sick from drinking Masai cow blood.

[Candy Vega]

My daughter had quite a bit of blood on her panties which the p.a. said it looks like she broke a vessel? But to me it looks like way to much blood, how much blood can come from constipation?? Thanks

[A Reader On Constipation Remedies]

As you suggest, one common way to reduce constipation is by adding foods rich in fiber to the child's diet. What some people don't know is that adding sorbitol also helps reduce constipation. Sorbitol is rich in prunes and pears, which is not surprising as prunes (which are dried plums) are a well-known food for helping bowel regularity.

[Constipation Home Remedies]

The most important causes of chronic constipation are a faulty diet and style of living.

[treatment of hemorrhoids]

Thank you for articulating some great points. When ever reading a news alert item I also trying and join the topic stream.

[somanabolic]

i think fiber can play an important role to avoide constipation

[Candahms]

My 7 year old Son has a problem going to the toilet sometimes.
he doesnt go in shcool coz its dirty or they dont have soap there ---- he stops his motion from coming by squeezing his butt.
Also he stains his underwear as well coz of that - then ends up having involuntary bowel incontinence.
just coz there is no soap there !
now imagine when there is not going to be water ?
here at home, once there was no water ----- even though there was water and a bottle there and mug and bucketfilled with water -- he did not wash and was simply sitting --- he says he cannot wash without pipe(faucet) coz he needs to spray his butt clean then wash it well with soap.
Now my problem arises because we will be going to Canada in a few weeks and there they DO NOT HAVE WATER in any of the toilets!!!!!!!! We can take a small bottle or use wet wipes , but i dont know how is he going to manage --- he cried when there was no faucet at home. i think he is going to fall back into his incontinence cycle when he goes there.....any advice or support is appreciated. =(

[tacfit]

fiber is beneficial against constipation

[Maria Stockton]

Children mostly suffer constipation because they are so picky on their food and most kids i know dont much like to vegetables, which i think is very helpful in preventing constipation. thank you for this helpful post.

[Susanne Richardson]

Fiber is very important in our diet. we should always include this in our meal to prevent constipation and other complications.

[supra tk society]

Liked you on Facebook, too. =)