My Child Is Constipated: Chronic?

My Child Is Constipated | Your Child May Be Experiencing A Chronic Problem Requiring Diet Changes

My child is constipated: Is chronic & common. Organic, medical & functional steps. Persistent constipation & actions

Constipation in infants and children

My child is constipated: Constipation in children is a common problem. It needs to be identified early and medical problems need to be ruled out before labeling it functional constipation.

It needs to fulfill two out of the following criteria. There is reduced frequency of stooling, passing of hard stools, pain during defecation, a lump of stool in the rectum and involuntary passage of stools in toilet-trained children.

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Medical or organic constipation:

A doctor will look for medical problems like thyroid, spinal problems, narrowing of the anus and other anomalies. The first black stool a baby passes called meconium should be passed within the first few days of birth.

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My Child Is Constipated

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Functional constipation:

However, It is the commonest condition and is related to dietary factors, behaviour issues, and toilet training problems.

Diet:

Dietary issues include poor intake of fiber and water. The modern diet is a contributor to childhood constipation. Unlike previous generations, children today consume large amounts of highly processed food items at the expense of fruit, vegetables, and fiber. Nonetheless, prescribing fiber works only for mild and not severe constipation.

Cow milk allergy:

Another important factor is cow milk protein intolerance. In a study, 68% of children with chronic constipation improved when they were switched to soy milk as compared to none of those who continued to drink cow milk. Often these children have associated eczema, colds, wheezing. Their bowel is inflamed as a result of an allergy to the cow milk protein.

Behaviour problems and toilet training

Often behaviour problems ensue with faulty toilet training. Too early toilet training especially when the child is not ready or if unnecessary pressure is put on the child it may result in the withholding of stool. To master toileting, a toddler must develop the ability and interest in retaining a bowel movement until it can be released into the toilet.

This behavior frequently leads to less frequent defecation, and sometimes too hard and painful stools, which in turn lead to further voluntary withholding. The problem may be exacerbated if toilet training is vigorously encouraged before the child is developmentally ready. Power struggles may develop if toilet training is forced on a child by a parent, potentially leading to various problems, one of which is constipation.

How does constipation persist

The bowels of young children are soft. When the rectum is stretched with the loading of large hard stools they stop working properly. The hard stool causes impaction and the child finds it painful to pass it. This results in the further withholding of stool making worse.

Sometimes runny stool comes out from the side of the hard impacted stool mass and the child passes it in his clothes. This is called encopresis. Sometimes the hard stool can cut the anal opening causing bleeding and more pain. These are called anal fissures.

What should be done?

  • Stop cow milk
  • Improve diet
  • Remove the hard stool by help of enemas
  • Give mild laxatives for 10 days
  • Give probiotics
  • Make toileting a pleasant time
  • Make a habit of sitting on toilet 2 times a day
  • Star chart
  • Maybe lignocaine jelly to prevent pain whilst passing stool
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My Child Is Constipated

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My Child Is Constipated: Chronic? was last modified: April 2nd, 2017 by Dr. Rajeshree Singhania

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