Constipation in Children

Gastroenterologists at Johns Hopkins Children’s Center have recently reported a 30 percent increase in the number of serious or chronic bouts of constipation experienced by American children between 2008 and 2009. While it’s unclear if the rise in severe cases is related to delayed diagnosis or insufficient treatments, Hopkins researchers contend that a lack of physical activity, low-fiber diets and insufficient consumption of water are likely contributing to the problem.

The Mayo Clinic defines chronic constipation as a two week period marked by several days between bowel movements that are accompanied by hard, dry and difficult-to-pass bowel movements and abdominal pain, irritability, nausea, poor appetite, or bright red blood on the surface of hard stools. Parents should also seek medical advice if they notice symptoms like abdominal bloating, forceful straining with bowel movements, and/or lumpy, hard or small pellet-like stools along with a feeling lingering fullness. Children with serious constipation often refuse to go to the toilet, hide in order to maintain privacy, soil their underwear and/or wet their beds.

While the quality and frequency of bowel movements varies from one child to another, it is important not to ignore symptoms of constipation. Chronic sufferers may experience encopresis (the involuntary leakage of feces that occurs in 60% of children with chronic constipation) which invariably results in shame, guilt, isolation and social stigma, and they may also distend their bowels causing nerve damage to their GI tracts and even experience rectal prolapse.

What to consider if your child begins to show signs of constipation:

  • increasing fluids and exercise
  • decreasing all dairy consumption
  • teaching relaxation techniques (particularly deep, slow breaths while relaxing the pelvic muscles)
  • regular abdominal massage
  • supplementing with magnesium
  • introducing a multi-species probiotic that contains Lactobacilli and Bifidobacteria
  • adding age-appropriate fermented foods like sauerkraut, tempeh, or miso
  • increasing dietary fiber (A good measure is 5-6 grams of fiber plus your child’s age. For instance, a 5 year old should have 10-11 grams of fiber per day.)

Raw fruits and vegetables have the most fiber, but cooked ones are also beneficial. Remember that the harder a vegetable is, the more fiber it has. Keep in mind that in order to reap the benefits of fiber, it is very important to drink adequate amounts of water (a minimum of 3 glasses) to help with the passage of stool in the intestines. If your child requires more than these general lifestyle and dietary changes to manage his/her constipation, please contact us for a consultation:  415.826.1701.