Constipation in Children
Constipation in children is common, although many parents never seek medical treatment for this condition. Constipation is defined as infrequent or hard bowel movements and may be the result of insufficient fluid consumption or a diet deficient in fiber. The frequency of bowel movements varies among individuals, so what is normal for one child may be abnormal for another. Generally speaking, if a child has three or fewer bowel movements per week or if stools are consistently hard, dry, and difficult to pass, the pediatrician should be consulted.
Causes of Constipation in Children
Constipation in children can be linked to various medical conditions but most cases of constipation are related to diet and environmental factors. Constipation may be caused by one or more of the following:
- Insufficient fluid consumption
- Lack of sufficient dietary fiber
- Irritable bowel syndrome or other disease conditions
- Certain medications
- Hormonal imbalance
- Overuse of laxatives
- Spinal cord damage
- Lack of exercise
- Damage to the spinal cord
In some cases of childhood constipation, the problem results from a suppression of the urge to have a bowel movement. This can occur for a number of physical reasons, such as pain in the anal region, or for psychological reasons, often associated with toilet training. Constipation can be self-perpetuating since a child who experiences pain when attempting to move the bowels may try to avoid passing stool, worsening the problem.
Symptoms of Constipation in Children
Apart from the obvious infrequency of bowel movements and the difficulty in passing stool, children who are constipated may experience the following symptoms:
- Rectal pain during a bowel movement
- Abdominal pain
- Traces of fecal matter in the underwear
- Blood on the surface of hard stool
Traces of fecal matter in the underwear may indicate that stool is backed up. While most cases of constipation in children aren't serious, chronic constipation may signal an underlying disorder. In some situations, the constipation itself may lead to complications.
When constipation is accompanied by any of the following symptoms, prompt medical attention is required:
- Blood in the stool
- Abdominal swelling or bloating
- Weight loss
- Rectal prolapse (intestinal protrusion through the anus)
- Anal fissures (tears in the skin)
After taking a history of symptom development, the doctor will do an examination and make treatment recommendations. In rare cases, diagnostic testing will be prescribed to rule out any serious disorders.
Treatment of Constipation in Children
In most cases, childhood constipation is temporary and fairly easy to remedy. Parents can usually help relieve their child's constipation by implementing a healthy, balanced diet rich in fiber and encouraging the child to drink plenty of fluids and to exercise daily. It is also important that children be encouraged. not to delay moving their bowels once they feel the urge.
When constipation is persistent, however, it is important to seek medical attention. The doctor may recommend:
- Fiber supplementation
- Mild laxative use
- Stool softeners
- Rectal suppositories
- Mild enema
If a large amount of stool is in the colon, a stronger enema may have to be administered in a hospital setting. This is called a disimpaction. Once the bowel is cleared, it is important to make lifestyle, especially dietary changes, to avoid recurrence of the problem.