What is constipation?
If your child begins to have stools less frequently than his usual stool pattern or if he is aving less than 3 stools per week he is constipated.
What other signs and symptoms are seen in constipation?
Stools that are large, painful or difficult to push out are common in constipation.
How might my child act?
Your child may act fidgety and restless, squirm in his chair, sit on his foot and squeeze his buttocks together in an attempt not to have a bowel movement. He is trying to avoid having a bowel movement which he has learned causes him pain and discomfort. These behaviors are a sign of the colicky pain seen in a child who is constipated.
How common is constipation?
It is one of the most common gastrointestinal complaints in children.
Does diet cause constipation?
Often children eat food high in fat and low in fiber and do not take in enough water. These are common dietary causes of constipation as is a diet high in milk products.
Does exercise effect constipation?
Yes. Children who move more and live an active lifestyle have a shorter transit time for food to move through their intestines. This helps prevent constipation. Children who sit for extended periods and are inactive have more problems with constipation.
Do emotional concerns play a role?
Yes. Emotional concerns depend on the child’s age and developmental level. Some toddlers can develop anxiety and be overwhelmed by a toilet training program. Other toddlers or older children use it as a way to assert their independence and engage in a power struggle with their parent. Older children often avoid using the bathroom in school and this can cause them to stop responding to signals telling them to have a bowel movement. Over time this causes the typical stooling pattern to become disrupted. This is also seen in children who are very active and on the go and do not take time to use the bathroom.
Can stress cause constipation?
Yes. Children of all ages are prone to body complaints related to moderate or severe toxic stress at home or at school. Numerous functional complaints can be seen including stool retention.
What other symptoms are seen with constipation?
Your child may have a decreased appetite and sleep disruption. There may be smearing of underwear with a small amount of stool due to a leak of liquid or soft stool.
How does the pediatrician diagnose the cause of the constipation?
By taking a thorough medical history and performing a comprehensive examination your pediatrician will determine whether the cause is functional or is due to an organic problem.
What type of information should I collect to tell my pediatrician?
If your child is less than 1 year of age the time of his first stool in the newborn period will be important as will the pattern of stooling up to the time when stool frequency decreased. For older children the pattern of onset is important as is stool description, frequency and the way your child responds to signals of needing to have a bowel movement. Keep a food log for 1 week and see how much fluids your child drinks. Check his urine color to see if it is clear throughout the day or is yellow and concentrated. Check your child’s underwear for staining and look for behaviors that may signal he is holding back the urge to defecate.