Constipation is a common problem among children. It is usually defined as the passage of hard and painful stools or decrease in bowel movement. You only need to worry about the firmness or frequency of your child's bowel movements if it seems to be causing a problem, such as pain while passing motion, stomach pain, irritability, and lack of appetite.
Once a child develops constipation, he or she may begin to hold his bowel movements to avoid experiencing pain again. This creates a vicious cycle that prolongs the constipation problem and worsens the situation.
Common causes
Constipation is most commonly caused by a diet that is low in fibre, not drinking enough water, or waiting too long to go to the bathroom. Young children with long-term constipation often ignore the urge to have a bowel movement.
Treating Constipation
Some measures to treat and prevent constipation include:
1. Dietary Changes:
Increasing fluids: Increase the amount of water and fruit juices, such as prune juice, that your child drinks each day.
Increasing fibre: Consume more food that is high in fibre such as cereals, fruits, and vegetables.
Decreasing constipating foods: Reduce consumption of food like cow's milk, ice cream, cheese, and yogurt.
2. Medication for constipation:
Dietary changes take time to become effective and until they do, your child may need medication such as the following:
For oral use:
- Lactulose: Draws extra fluid into the intestine to soften the stools. Some children may find it too sweet. It may be diluted with fruit juice or water to improve the taste. It is often used for long-term constipation and is considered to be safe, effective and non-habit forming.
- Liquid Paraffin: Softens and lubricates the stools, making it easier to pass.
- Psyllium Husk: A bulk laxative that supplements the fibre in the diet. It is important to increase fluid intake as well, as fibre requires fluid to work.
- Bisacodyl: A stimulant laxative that stimulates the intestines to contract, thus causing the movement of the bowels. It is also available in suppository form.
- Senna: An herbal stimulant laxative in tablet form.
Note: Liquid paraffin, psyllium hulk, bisacodyl, senna are not suitable for children under 6 years old.
For insertion through the anus:
- Glycerin suppositories/ Mini-enemas: May be used if faster bowel movement is deemed desirable, after weighing the benefits and risks.
Always consult your healthcare professional before administering. Call your doctor if your child's constipation problem does not improve in 2 weeks or if he or she needs to use enemas or suppositories regularly.
3. Bowel habit training:
Once your child's stools have become soft and regular, it is important to encourage him to have regular bowel movements. Have your child sit on the toilet for about ten minutes after meals at the same time each day. Make sure your child can place his or her feet firmly on the floor while sitting on the toilet.
A reward system may help. Reward your child for just sitting on the toilet. If your child has a bowel movement, give your child praise and a reward. Try not to use food as a reward.
Most importantly, be patient. Constipation in children takes time to improve. Avoid embarrassing or punishing your child, as this may make your child more resistant to behaviour modification.
Constipation can usually be controlled with a good diet, improvement in bowel habits, and appropriate use of medication.