Is your child silently suffering from this condition?
As parents, we typically pay attention to what’s in our baby’s diaper, often analyzing bowel movement consistency, color and frequency. But as children grow and successfully potty train, we aren’t as aware of their bathroom habits as we once were.
Many young children silently suffer from constipation and fecal soiling because they don’t know how to articulate what is going on with their body.
Constipation is the passage of hard, dry stool. Patients who are constipated can have small or large stools, and bowel movements can be infrequent or daily. Another sign of constipation is withholding, where your child may refuse to pass a bowel movement.
Constipation is typically caused by a low-fiber diet, inadequate fluid intake, organic or functional problems. Remember to keep your child hydrated, especially during the hot summer months. Serve them foods with an adequate amount of fiber. Check-in with their pediatrician to determine the appropriate amount of daily fiber for your child. Scheduled toilet time is very important. The best time to sit on the toilet and pass bowel movements is after meals because of the physiologic movements that occurs in the GI tract.
Patients with chronic constipation may also suffer from the involuntary passage of stool, oftentimes causing your child to have an accident. This type of fecal soiling occurs when there is a large, hard stool mass in the rectum. The newly made stools, which are soft or loose, will bypass this hard mass. The patient will then leak out stools without even noticing. This can be extremely embarrassing for your child. It’s important not to scold them when this happens. Speak with their pediatrician to determine the cause of the accidents.
Depending on the child, treatment for constipation and fecal soiling can include diet modification or improvement, behavior changes, taking stool softeners temporarily or long term and incorporating a bathroom schedule until your child begins to have an easier time using the bathroom. Because constipation tends to be a chronic condition, it’s important to be patient with your child’s treatment course.
Check in with your child about their bowel movement frequency and consistency. Even if you don’t notice it, they may be struggling. If your child is experiencing hard, infrequent stools or is having accidents, contact their pediatrician.
Dr. Zahra Nouri is a pediatric gastroenterologist at Aurora Children’s Health.
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About the Author
Dr. Zahra Nouri is a pediatric gastroenterologist with Aurora Children's Health.
Very nicely summarized Dr Nouri. A lot of children have bladder problems such as incontinence/UTI secondary to the constipation. Constipation can be quite difficult to diagnose and treat. Especially, the paradoxical constipation that you talked about.
Dietary modifications are mentioned above, how often do you check for food allergies vs more fiber? Incontinence and frequent constipation can be undiagnosed food allergies often over looked by traditional medicine. And curious what the stool softeners that are suggested from you considering the the EB research on brands like Miralax and children and that being the only suggestion from pediatricians in my experience.
Vomiting, diarrhea, respiratory problems, and poor growth are more commonly seen in food allergies rather than constipation.
Lactulose and Magnesium Hydroxide are other types of osmotic laxatives.
My granddaughter has bowel issues. The problem with her is her stools are so big that she dont want to go to the bathroom cause it hurts her so bad and her little area gets raw or chapped and sometimes bleed like a diaper rash. Then sometimes she has the accidents like mentioned in this article. Her doctor says she can take Miralax to help loosen the stools. She drinks tons of water daily, eats her fruits and vegetables and gets plenty of fiber but this still occurs. What do you suggest now?
She needs to take Miralax to keep the stools soft. It is important to have scheduled toilet time. She needs to sit on the toilet for 5-10 min after each meals and try to pass a bowel movement.
She will need to see a GI specialist if she continues to have accidents and/or large hard stools despite following the above recommendation. Sometimes patients will require home bowel clean out to flush the large stool collection out.