There are many reasons for constipation in children. This article lists them out and gives out solutions to rid off the problem.
By Dr Vivek M Rege
Occurrence of two or more of the following symptoms over the 2 most recent months if the child is >4 years of age, and 1 month if the child is <4 years of age:
The wrong type of food, with inadequate fibre, causes low residue and leads to constipation. This, in turn, causes loss of appetite, which again leads to decreased intake and further constipation. In almost 90% of cases, this is the cause of constipation.
Constipation can be a side effect of drugs prescribed for other diseases.
Anatomical/structural causes like small size of the anal opening or the anal opening being situated slightly ahead of the usual position. These will require surgical intervention.
Being born with an abnormal intestine, mainly the large intestine - this condition is called Hirschsprung disease.
Refusal to pass stools: as passing stools can be painful for an already constipated child, he tries to avoid it. This makes him lose his appetite. With reduced intake, his constipation gets aggravated. Thus, the whole condition is a vicious circle.
Excessive milk consumption: for two-year-olds, being fed milk through a bottle with a nipple is the reason. These children are given 4–5 feeds of milk every day, which is almost 1 litre of milk. This leaves no space for eating any other food.
Insufficient water intake: due to lack of physical exercise, children, these days, do not consume sufficient water and fluids. This easily triggers constipation.
Correction of the diet: this is the first and the most important step. Parents need to consider the following elements while planning their children’s diet:
Physical activity: Parents should engage their children in physical activity and exercise. They should ensure their children are not spending too much time with gadgets, and instead, play outdoors.
Stool softeners: Under the strict medical supervision and regular follow-ups, some stool softeners and digestives may be given. However, once the diet becomes normal and balanced, these medications should be discontinued.
Potty training is a good preventive measure. Ideally, there must be a fixed time for potty in the morning. For very young children, there should also be a fixed time for potty, say 20-30 minutes after both major meals. Such training should last for at least six months until the child gets into the habit of completely emptying his bowels, and it becomes a routine, almost like a reflex action for the child.
I hope these inputs will help parents ensure their children lead healthy lifestyles – eating right and exercising well. And, let the children say with ease every morning, “pooh! I pooped.”
Dr Vivek Rege is a consultant pediatric surgeon & pediatric urologist at Bhatia Hospital, Mumbai.
To know more about Causes and Cure, go through the pages of this ClipBook.
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