Constipation in children
What is constipation?
Constipation is the problem where children pass hard stools or pass stools less regularly. The frequency of stool varies from child to child. Passing stools anything from 3 times a day to once every alternate day is normal. But if a child passes stools less often than every other day, most people agree that they suffer from constipation. However, what is more important is that babies pass soft stools easily. A recent change in the consistency of stool is also an important indicator of constipation.
How can parents recognize that their child suffers from constipation?
Here are some of the signs that can make parents suspect that their children suffer from constipation:
Passage of hard stools. They can look like small pellets or large hard stools.
Difficulty or straining to pass the stools.
Passing stool less than 3 times a week.
Child complains of frequent tummy pain.
Child complains of pain or cries when passing stool.
Bright red blood noted around the stool (due to formation of anal fissure).
Episodes of accidental soiling where the child passes liquid stools involuntarily.
What are the causes of constipation in children?
In most children, constipation is due to non-medical causes. It is called functional constipation. Only in a small proportion of children, it is caused due to medical causes. The following are common causes of functional constipation.
Not taking enough liquids every day.
Taking a diet low in fibre and high in dairy products.
Delay in passing the stool due to voluntary holding. This can be because they don’t want to stop what they are doing or want to use an unfamiliar or dirty toilet. This makes the stool hard and dry.
Decreased physical activity.
Decreased intake of food during illnesses etc.
Some medicines might make constipation worse.
Why do children have faecal soiling in constipation?
In children with long standing constipation, there is impaction of faeces (blockage of the bowels with faeces). As a result, the bowel is stretched and the child soils himself with soft liquid faces. This can be mistaken for diarrhoea. This can cause a lot of embarrassment for older children.
What is anal fissure and how is it caused?
Anal fissure is a tear in the skin of the back passage (anus). It is caused due to passage of a large, hard stool. Once constipation is treated and the child passes soft stools, the fissure heals automatically.
How can we treat constipation?
Constipation can be treated by dietary modification, toilet training and medication where necessary.
Dietary modification: Increasing intake of liquids and fibre in the diet can help constipation. Aim for 6 to 8 glasses per day. Babies above 6 months can have water in between feeds.
Increase fibre in the diet can be achieved by taking a diet rich in wholegrains, fruit and vegetables.
Try pureed fruit and veg for babies.
Examples of fibre rich foods
Toilet training: Set a toilet time each day. Make it fun with books etc.
If it hurts, tell them to stop and try again.
Slight changes in sitting posture can make it easy for kids.
Medication: sometimes your doctor will prescribe medication to soften stools (laxatives) to help your baby pass stool easily and without pain.
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