Constipation
Constipation in children is a frequent issue, often causing discomfort and distress for both the child and their parents. It can be due to various factors, including diet, toilet training, and lifestyle changes. It happens when your child has hard, dry or lumpy stools that are difficult to pass. If your child has fewer than two bowel movements per week, they may have constipation. Although constipation usually isn’t serious, it can cause uncomfortable symptoms for your child. In most cases, constipation can be treated at home. However, when home treatment is unsuccessful, the caring and experienced team at the Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition can help.
Symptoms
Children who are constipated may be cranky or listless. Your child may also be afraid of using the toilet, since passing stool can be painful with constipation.
Other symptoms include:
Infrequent bowel movements: Fewer than three bowel movements per week
Hard, dry, or lumpy stools: Stools that are difficult or painful to pass
Straining: Excessive effort during bowel movements
Abdominal pain: Cramping or pain in the stomach area
Rectal bleeding: Blood on the surface of hard stools
Withholding behavior: Child may avoid going to the toilet due to pain or fear, leading to stool retention
Soiling: Stool stains in the child’s underwear due to leakage of liquid stool around hard, retained stools
If constipation continues, it can lead to a condition called fecal impaction, which is when stool is packed so tightly that the normal pushing action of the colon can’t move it out of the body. Ongoing constipation can also lead to hemorrhoids or small tears in the anus called anal fissures. In addition, pressure from stool in the colon can push on the urinary tract and block the flow of urine, causing a urinary tract infection.
Call your child’s doctor right away if he or she has bloody stools, vomiting or abdominal pain that doesn’t go away.
Diagnosis
If home treatment for constipation hasn’t helped, your child may need to see a gastroenterologist at the Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition to look for an underlying cause. Constipation often results from poor diet, being inactive and not drinking enough fluids. With this in mind, your child’s doctor will ask about their diet and lifestyle habits, including physical activity and any medications or supplements, since some of these can also contribute to constipation.
Diagnosing constipation in children involves a thorough assessment which includes:
Medical History: Reviewing the child's bowel habits, diet, fluid intake, physical activity and any recent changes in routine or stress levels.
Physical Examination: Includes an abdominal and possibly a rectal exam to feel for stool masses. Your doctor may also look for signs of dehydration and check your child’s abdomen for tenderness or swelling.
Diagnostic Tests: Usually reserved for persistent cases
X-rays: To detect stool accumulation in the intestines.
Blood tests: To rule out metabolic or endocrine disorders.
In many cases, especially in older children, constipation develops when they avoid going to the bathroom. This can happen when kids don’t want to stop playing, or when they start school and find that the toilet is less private. Emotional problems lead a few children to withhold stool. Your child’s doctor may ask questions to determine if any of these issues are contributing to constipation. In some cases, imaging or lab tests may be needed to check for signs of an underlying condition.
Treatments
The first step to treating constipation in children is to help them empty their bowels. Your doctor may recommend a series of enemas or large doses of stool softeners. Stimulant laxatives can sometimes help as well. All these options are safe for your child.
Once the lower bowel is empty, slowly reduce the amount of laxative or stool softener your child is taking by cutting the dose a little every week. Your child’s doctor will tell you how long this process should take.
It’s important to keep stool moving so the bowel can regain its function. These steps can help:
Provide fiber-rich foods. Include plenty of fresh fruits and vegetables in your child’s meals. Unprocessed bran and whole-grain breads and cereals are also good sources of fiber.
Increase fluids. Make sure your child drinks plenty of water or other liquids, such as fruit juices, vegetable juices or clear soups.
Help your child get more exercise. Being physically active helps stimulate the intestine to move stool.
Encourage good bowel habits. Have your child use the toilet after each meal, and give him or her sufficient time in the bathroom. It can help to put a box or other support under their feet to raise their knees higher than their hips. This is the best position for a bowel movement.
We offer specialized pelvic floor therapy for the treatment of constipation, utilizing advanced anorectal manometry combined with biofeedback sessions. This comprehensive approach helps patients effectively manage and treat pelvic floor disorders, specifically addressing chronic constipation and improving overall bowel function.
We also provide integrated medicine, seamlessly blending conventional therapies like laxatives with complementary approaches such as yoga. Specific yoga poses engage and strengthen the muscles of the abdomen and pelvic floor, addressing concerns like fecal incontinence or pelvic floor dysfunction that can exacerbate constipation.
If your doctor feels that emotional problems could be causing your child to withhold stool, they may suggest a counselor. At the Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition, our child psychologists are experts at helping kids change harmful habits and establish healthy ones.
Next Steps
When your child has a digestive health problem, such as constipation, it can be stressful for the whole family. At the Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition, our gastroenterology specialists, psychologists and registered nurses understand your concerns. We have the skills and experience to find the answers you need and to design a personalized care plan for your child.
In the unusual case that your child has a more serious condition, you can count on us for the latest treatments and the highest level of care. Our multidisciplinary approach puts a team of specialists together with you and your child to determine the best diagnosis and treatment strategies.
We answer all your questions and include you in treatment decisions every step of the way. You and your child are the most important members of your care team.
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