Dr Gary Katz | Consultant Paediatrician | The Portland Hospital
Many children suffer from constipation from time to time. There are a variety of reasons for this but there is hardly ever a medical cause.
Constipation occurs most commonly in children aged 2 to 4 when they are being potty trained. It also occurs relatively commonly in babies. About one third of children between 4 and 7 can be constipated at any one time. As a rule the constipation only lasts for a short period.
The causes of constipation are either dietary factors or behavioural factors. Dietary concerns are in children who do not have sufficient water or do not eat an adequate amount of high fibre food, thus stools become harder and drier and more difficult to pass. If a baby or toddler drinks too much milk, they feel full and are less likely to take solid food. Behavioural issues account for a large number of children starting to ‘hold back’ when they are begin potty trained. Putting off going to the toilet, increases the likelihood of the child becoming constipated. Changes in the daily routine can also upset the bowel pattern.
The signs and symptoms parents need to watch out for constipation are as follows:
• Going less frequently than usual (that is less than three bowel movements a week)
• Passing small dry, hard stools
• Pain and straining when passing a stool
• Avoiding the toilet
• Sore bottom
• Bleeding from the back passage
• Tummy ache
• Loss of appetite
• Feeling sick
• Dribbling of urine
• Overflow diarrhoea (when a large stool gets stuck and blocks the child’s bowel, liquid stools from above the blockage can flow around the stool and leak into the underwear. This is a sign of severe constipation.)
In order to prevent or manage your child’s constipation, the following approaches could be tried:
Eating more fibre
A poor intake of dietary fibre is an important cause of constipation. As fibre cannot be digested by the body it passes straight through the digestive system increasing the bulk of the stools and making them softer by helping to retain water. It is important to include high fibre foods with each meal and snack: Breakfast – cereals such as Weetabix, Oatibix, Sultana Bran, Bran Flakes, Shreddies and porridge oats and use wholemeal bread. Lunch and Dinner – wholemeal pasta, brown rice, vegetables, fruit, pulses such as beans, chickpeas and lentils. Snack time – high fibre biscuits, oatcakes, fig rolls, cereal and muesli bars as well as fruit.
Increase your child’s fluid intake to approximately 2 pints/1 litre daily
This should be mainly water but fruit juice is also helpful.
Do not allow your child to wait too long before doing a poo. It is best to set aside a time each day, preferably after a meal, for the child to sit on a toilet. Give your child enough time on the toilet so that they don’t feel rushed. It is also helpful to a child to have lots of active play during the day.
Where the above measures are insufficient, medication is needed. A variety of laxatives will help to clear the build-up of poo. The most helpful of the medications is Movicol; other popular medicines include Senokot and Lactulose.
Each child’s medical needs differ so it is vital that you seek advice from your doctor regarding the best method to relieve your child’s constipation.
Dr Gary Katz, Consultant Paediatrician at The Portland Hospital can be contacted on 07889 522501.