Why your child is likely to be constipated

Going to the toilet regularly is something most of us take for granted. However, for some children, it can be an ordeal.

For them, the thought of going to the toilet fills them with dread and fear due to the pain and discomfort they experience during these moments.

MOST VULNERABLE TIME

Infancy: Babies who mix breast and different formula milk feeds may experience constipation.

Weaning: The change in diet from milk to solid food takes a little getting used to and it is not unusual for infants to develop constipation.

Toilet training: Some children rebel against toilet training and go on to hold their stool in any time they are required to sit on the potty. This ‘holding it in’ habit can be a precursor for constipation as the child gets older.

Starting school: Starting school can be a challenging period even for the most confident child. Usually, getting into a strange environment and starting on a new feeding schedule (sometimes with new foods) can contribute to constipation.

WHY IS YOUR CHILD CONSTIPATED?

Diet issues

Most children with constipation have poor diet as the major contributor to their problem.

Food processing has played a great role in this. Most of the fibre is reduced considerably during the refinement process yet it is crucial for a healthy digestive system.

Most children prefer eating foods like biscuits, mandazis, white bread and other refined food products instead of healthier options like oats, bran and brown bread.

They opt to drink juice instead of eating actual fruits. Sadly, most of these habits are imparted on them by their parents. Food allergies such as cow milk allergy can also contribute to constipation.

Imperforate Anus (missing anal opening)

This is when your baby is born without an anal opening. Usually, this is noted by your child’s doctor or midwife soon after birth. It can occur as a solitary defect or it may be associated with other abnormalities (in the heart, limbs, spine, genitals and in other parts of the digestive system). Usually, the child will need surgery soon after birth to correct the problem.

Hirschsprung’s Disease

This is a disease in which part of the intestines do not have proper nerve supply and are thus unable to empty their bowels properly. Usually this is noted within the first two years of life. It needs special tests to see which section of the intestine is affected. Once the condition is detected, treatment is surgical.

Bowel blockage

If your child suddenly gets constipation with associated abdominal pain and vomiting, there could be blockage in the intestinal system (medically known as obstruction).

This is usually an emergency that requires immediate medical attention.

Hormone and brain/spine issues

Thyroid problems can lead to constipation. In addition, children with nerve problems such as cerebral palsy may develop constipation and feeding problems.

Medication

Children on high doses of iron supplements or certain pain medication may get constipation as a side-effect.

COMPLICATIONS OF CONSTIPATIPATION

Anal tears

Sometimes, a child can develop small tears in the anal opening due to constipation. This occurs as a result of pushing out large, hard stool. This presents with pain and bleeding when going to the toilet.

To avoid the pain, the child would then to hold in the stool for as many days as possible. This only worsens the constipation and when the child eventually has to go, the process is worse than before.

Constant abdominal discomfort

Children with very severe constipation never fully ‘empty’ themselves when they go to the toilet. The stool accumulates in the intestines and can even be felt when you touch the child’s belly.

This can be a source of discomfort for the affected child.

Soiling
Children with severe constipation usually find the accumulated stool leaking out when they least expect it. It is, therefore, not unusual to find their underwear, sleepwear and beddings soiled from time to time.

Poor self-esteem

Children who soil themselves as a result of constipation may get poor self-esteem as a result of being mocked and bullied by their siblings and peers (sometimes parents and teachers worsen this situation by putting the child down in a misguided attempt to try and get him or her to change their bathroom habits).

In addition, constipated children whose younger sibling has regular stool habits may think that they are ‘inferior’ or ‘less intelligent’ than their brother/sister.

Poor growth

Older children begin to realise that eating results in a need to go to the bathroom. To avoid this, these children begin to refuse to eat which contributes to poor growth.

Loss of academic time

Severe constipation may require hospital admission to ‘wash out’/cleanse the child’s digestive system. There are also numerous doctors/nutritionist appointments to be attended. This usually leads to loss of valuable school time.

WHAT CAN YOU DO?

Talk to your doctor

The first thing to do is to try and find out if the child has a medical condition or if it is just simple constipation. Depending on the age and other features in your child, several tests may be needed.

Dietary changes

This is the cornerstone of managing constipation. Children need sufficient fibre and fluid to ensure a healthy digestive tract. Cereal, fruits and vegetables are the most crucial requirements in this age group. If you are not sure whether your child’s diet is appropriate, seek the help of a nutritionist/dietician.

Improve toilet habits

Encourage your child to use the bathroom at regular times during the day, especially after meals and whenever he or she feels the urge to go. Let them sit on the toilet for at least 10 minutes at a time. Sometimes, putting a small stool under your child’s feet can improve the posture they have while on the toilet making it easier for them to empty their bowels.

Medication

The main drugs used to manage constipation are known as laxatives. These usually soften the child’s stool and cause them to pass stool more regularly. Sometimes, the child may require rectal tablets (suppositories) to help them pass stool more easily. If the anus has tears, there are special ointments that are given to help them heal and prevent pain when passing stool.

Get them moving

Children who are physically active have better bowel habits than their sedentary counterparts. For this reason, ensure that each child gets sufficient exercise/play on a daily basis.

This article was first published in the Business Daily.