Constipation: Surprising truths and tips for relief

Constipation is aniStock_000022525603_ExtraSmall 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?

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10 Responses to Constipation: Surprising truths and tips for relief
  1. Ali
    January 16, 2013 | 7:36 pm

    I know it’s not a topic that everyone wants to talk about, but it’s important! It’s especially important for those who deal with low muscle tone and its related conditions. You don’t realize how crucial it is to have properly working intestinal muscles until you don’t have them! Thanks for sharing.

  2. Ruth
    January 17, 2013 | 6:39 am

    Are there foods to avoid in addition to the foods they should consume? My son had the telltale signs of “impaction” (leaking stool, no bm for 2-3 days, then a huge hard bm when he did go) a couple of weeks ago. A suppository helped him out that time but we are still struggling to get him enough fiber, water, & exercise. The doctor gave suggestions, but he is still struggling. How long does it take to “get back on track” and then get ahead at this point?

    • Melissa
      January 18, 2013 | 9:41 am

      I would avoid starchy/sugary foods: think “white” foods like white bread, sugary cookies, fast food, etc. Here is a great run down on fiber rich foods to give children with some meal and snack ideas…http://kidshealth.org/parent/growth/feeding/fiber.html?tracking=P_RelatedArticle#

      For a child in this situation, laxatives are often a good way to get ahead and working closely with your child’s pediatrician on this is must. Good luck

  3. Sheena
    January 17, 2013 | 8:07 pm

    What kind of dietary fiber supplement is suggested for toddlers (2-4 yo)?

    • Melissa
      January 18, 2013 | 9:35 am

      There are children’s fiber gummies available for children ages 2 and older. Or fiber granules that can be added to water and/or juice. Prune juice in the morning worked well for my own children at that age. Good luck!

  4. Justine @ The Lone Home Ranger
    January 22, 2013 | 5:01 pm

    This is a timely post. My kids just got over constipation after they were on a round of antibiotics. I treated it with fluids and fiber as you said, plus no sugar/refined carbs for a while and a probiotic, and it resolved in a few days. I discussed these and other ways to rebuild good gut flora on my blog this week if you’re interested: http://www.lonehomeranger.com/2013/01/rebuilding-your-childs-gut-immune.html.

    FYI, for your readers interested in using laxatives, please note the recent FDA listing of Miralax and other polyethylene glycol-containing laxatives on the adverse event reporting system for neuropsychiatric events.

  5. Avoiding Constipated Children
    January 24, 2013 | 10:11 am

    I also think that teaching correct toilet position is also important see http://youtu.be/pYcv6odWfTM

  6. [...] Read the whole article here. [...]

  7. Matthew Allen
    May 18, 2013 | 5:07 am

    My toddler recently experienced some issues during potty training. He was afraid to go (#2) on the toilet. Fear of the unknown I think. Luckily, he got over his fear pretty quickly and it never led to serious constipation problems. But for a few days there, he was experiencing some real pain from holding it in. Thanks for the advice here.

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