About Constipation in Children
The root causes of constipation in children are not fully understood, but there are several factors that can contribute to this condition. These include:
- Withholding behavior: Children may voluntarily withhold their bowel movements due to fear of pain, leading to a vicious cycle of withholding and worsening constipation.
- Abnormalities in the natural process of fecal excretion: Constipation can be associated with disorders in various levels of the natural process of fecal excretion.
As for the non-modifiable risk factors, these are factors that cannot be changed or controlled.
- Unfortunately, there is limited research on this topic, so specific non-modifiable risk factors for constipation in children are not well-established.
On the other hand, modifiable risk factors are factors that can be changed or controlled. Some potential modifiable risk factors for constipation in children include:
- Low fiber diet: Not consuming enough fiber can contribute to constipation.
- Inadequate fluid intake: Not drinking enough liquids can lead to hard and dry stools.
- Ignoring the urge to have a bowel movement: Delaying or ignoring the urge to have a bowel movement can contribute to constipation.
- Changes in routine or pattern: Disruptions in routine or patterns, such as traveling or starting a new school, can affect bowel regularity.
It is important to note that these risk factors may vary among individuals. It is always best to consult with a healthcare professional for personalized advice and guidance.
The most common early symptoms of constipation in children include:
- Passing less than two bowel movements weekly
- Hard, lumpy, or dry stools
- Difficulty and pain when passing stools
- Feeling that not all stool has passed
- Swollen abdomen or bloating
- Daytime or nighttime wetting
- Stool in their underwear that resembles diarrhea
- Changing positions to delay a bowel movement, such as clenching the buttocks, rocking back on their heels, or doing dance-like movements
As constipation progresses or becomes more severe in children, other common symptoms may occur, such as:
- Stomach pain
- Traces of liquid in their underwear from backed up stool in the rectum
- Unusually large stools
- Abdominal swelling
- Flatulence
- Traces of blood on toilet paper due to small tears around the anus from straining
It is important to note that if constipation continues after 2 weeks or happens with other symptoms such as bleeding, you should take the child to a pediatrician for further evaluation and management.
To diagnose constipation in children, doctors commonly perform the following examinations, tests, and procedures:
- Physical examination: This involves a thorough evaluation of the child's symptoms and medical history. It may include a rectal exam, checking blood pressure, temperature, and heart rate.
- Stool tests: Doctors may test the stool for hidden blood to rule out other diagnoses.
- Additional testing: If the cause of constipation remains unclear, doctors may order further tests, such as blood tests, urine tests, colonoscopy, sigmoidoscopy, ultrasounds, and X-rays. These tests help identify any underlying conditions or abnormalities.
To determine the stage or severity of constipation in children, doctors may consider the following examinations, tests, and procedures:
- Rectal biopsy: This is the best test to diagnose or rule out Hirschsprung disease. It involves taking small pieces of tissue from the rectum and examining them under a microscope for signs of medical problems.
- Imaging tests: Ultrasound, X-rays, and computed tomography (CT) scans may be used to identify any structural abnormalities or blockages in the digestive system.
Please note that these examinations and tests should be performed by a healthcare professional.
The goals of treatment for constipation in children are to provide relief from symptoms and treat the underlying cause. Here are the different types of treatments and how they work:
- Medications:
- Laxatives: These help soften the stool or promote bowel movements.
- Enemas: They involve inserting liquid into the rectum to empty the bowels.
- Therapies:
- Dietary changes: Increasing fiber intake through fruits, vegetables, legumes, and whole grains can help regulate bowel movements.
- Probiotic supplements: These may improve digestive health and promote regular bowel movements.
- Regular exercise: Physical activity can stimulate the intestines and aid in bowel movement.
- Therapeutic procedures:
- Disimpaction: This involves removing a buildup of stool using agents like polyethylene glycol.
- Lifestyle changes:
- Developing a regular toilet routine, encouraging toilet use after meals.
- Using a reward system to motivate regular toilet use.
- Stopping toilet training until constipation resolves.
It is important to note that medication dosing and administration should be done under a doctor's guidance. Home remedies should be discussed with a healthcare professional before giving them to a child. If constipation persists or is severe, medical attention should be sought.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.