Constipation usually means difficulty in passing a stool; diminished frequency in opening of the bowels or the passage of hard, dry stools. Constipation is a common childhood problem.
The signs that a child may have constipation include:
- pain and straining when going to the toilet. A hard stool can tear the lining of the anus leading to more pain and bleeding.
- diarrhoea or soiling. When the bowel is blocked, as in constipation, the body attempts to pass a bowel motion by becoming runny and going around the blocked area. The child may have marks on their underwear or soil themselves when they are undertaking physical exercise. Constipation can also lead to a lack of sensitivity in the muscle of the anus itself so that the feeling of needing to go to the toilet is lost.
- stomach or abdominal aches and pains.
- other problems such as headaches, skin problems, poor concentration, muscle aches, bad breath and tiredness. These are all associated with the reabsorption of toxins from the bowel and their remaining in general circulation.
What are the causes of constipation?
The most common cause of constipation is a diet high in processed food and low in roughage. These are however, not the only causes. Other causes include the following.
- Not drinking enough fluids.
- Food allergies or intolerance. Allergies are often associated with cereal and dairy products.
- Eating too many wheat based product, such as bread and pasta.
- An imbalance in the gastrointestinal bacteria. A recent course of antibiotics or a diet that has a lot of processed foods and sugars can lead to an imbalance of the intestinal flora.
- Children who are too involved in what they are doing will sometimes ignore the urge to go to the toilet allowing the motion to become dry and hard to pass.
- Iron sulphate is added to some foods such as rice cereals, formulas and drinks such as Milo. In children who are sensitive to this it can lead to constipation.
- Stress and anxiety. Like adults the digestive tracts of children contract during stress. This can cause the bowel motion to pass through too quickly (causing diarrhoea) or too slowly, causing too much fluid to be absorbed, resulting in constipation.
- Insufficient exercise. Exercise is needed to activate the muscles of the digestive tract and to move the waste material through the intestines.
What can you do about constipation?
You need to treat the existing problem, that is clear the bowel of hard bowel motions, and then work on preventing the situation from recurring. What you can do:
- Massage to encourage movement through the large bowel. Have the child lie on their back and knees raised. With warm hands apply gentle pressure. Start from the lower right abdomen, work your way up towards the rib cage, then go across the stomach and down the left side. This is roughly the direction of the bowel and is helpful for stimulating the muscles to move hard stools.
- Use juices to assist the intestines. The juices can include prune, apple and lemon. Spinach, watercress and dandelion leaves can be added to milder juices such as carrot, cucumber, beetroot and celery. These can be used in small amounts or diluted.
- Increase the consumption of fibre rich foods. These include vegetables, fruits, nuts and seeds and at the same time reduce the intake of sweets, chocolate, cakes, bread and white rice. Don’t overdo the nuts though, as this can actually be constipating.
- Eat meals at a regular time so the bowel is able to get into the habit of moving at certain times.
- Increase the amount of water your child drinks. Children need to drink 6 to 8 glasses per day. Using milk, cordials and soft drinks can cause further problems so use filtered water and fresh natural juices as much as possible.
- Encourage plenty of physical activity.
- Increase the number of friendly bacteria in the bowel by the use of probiotics.
- Remind children to go to the toilet.
- Change the child’s position when they go to the toilet. Place a small stool in front of the toilet so they are able to have their feet on it and this will raise their knees and change the angle of the hips. This will place the child in a position that requires less pushing.. Squatting is the ideal position for all humans when defecating.
- Eat plenty of magnesium rich foods. Magnesium is important for muscle contraction and a deficiency in magnesium can cause constipation. Foods rich in magnesium include nuts, whole grains and beans.
- Add some psyllium seeds to the diet. For children who are prone to constipation a daily supply of psyllium seeds can help. This is a fiber that helps regulate the activity of the bowel. When mixed with water or diluted juices they can create larger and softer stools. In order to work effectively the seeds need to absorb water so the child needs to drink plenty of fluids. The dosage for children from 3 years of age is 1 teaspoon twice daily added to diluted juice.
- Talk to your child about any problems or stresses that they might have. Expressing concerns and receiving reassurance can greatly reduce stresses that may cause or contribute to constipation.
You will need to see a health professional if the constipation is difficult to relieve, if it is associated with a lot of pain or blood or if the child is doing all the right things and the problem is still there. Your health professional will consider the possibility of allergic problems and should explore this more thoroughly.