Everything you should know about Constipation in children - OnePharmily OnePharmily: Everything you should know about Constipation in children
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Wednesday, 10 October 2018

Everything you should know about Constipation in children

All you should know about Constipation in Children
All you should know about Constipation in Children 

I'm hoping by the end of this article you'll know a lot about constipation in children and will not have to wait till stool becomes as hard as a dried cement before taking action. 

Constipation can be annoying at times, especially when it happens to kids. 

I can recall a funny story from an old woman telling me about the stool of a baby that was very hard of which she had to use her fingers to gouge it out. Even after that, it refuses to be flushed in the toilet and she had to get a hammer and crush the evil thing into pieces. I wanted to laugh but considering how serious she looks I had to stop myself.

Constipation is defined as the passage of hard stool less frequently than the patient's normal pattern. This may be accompanied by sensation of pain or feeling of incomplete evacuation. Most people defaecate between 1 – 3 times in a day whereas others defaecate only once in three days.

In case of children, if the child did not defecate for at least three days then perhaps he/she is constipated. And, if by chance he/she defecates then the stool will be hard. 

Bleeding can occur after defecating because the stool is very hard and so the child had to strain before getting it out which might tear linings of the anus. 

A typical complain of a constipated child is stomach pain. This is because passing out stool is painful especially if tear had occurred in the anus. This can aggravate constipation considerably as a result of pain, which can cause the patient to have fears for defaecation.

Causes of constipation 

* For adults: some of the causes include: eating diet low in fiber, low fluid intake, lack of exercise, drugs and some disease conditions. 

*For  infants: There's is no specific reason that can cause constipation unless outlined by the mother. Such as adding rice to the baby's cereal in order to make the baby less or hungry or sleep more. So, the cause isn't specific. But this doesn't mean that it cannot be diagnosed. It should also be noted that a switch from breast milk to cow milk can cause constipation due to allergy.

* For children of at least 3 years: There are various factors that needs to be considered. This include;

#The kind of food taken or having bad eating habit. Food items such as pizza, bread, French fries etc are known to cause constipation in children. 

#When toilet training isn't done well such as a child that grow up using diaper and not properly taught how to use a toilet. 

# Hygiene is a major factor that can cause constipation in children especially in public or school toilets. 

Natural causes of constipation in children 

Sometimes the fault is neither from a child nor from a caregiver. Some children naturally lack the urge to visit the toilet which can lead to constipation. 

Others may be born with problems in the structure of the anal canal especially positioning.

In addition, some children might have a body system that slows down the movement of feces which might lead to constipation. This is due to the absorption of water from the feces as it slowly moves in the GIT. 

To some children, nerves that coordinate defecation might no be functional. 

Read also: How generosity decreases anxiety and stress

Signs of constipation in children 

Abdominal pain is a major sign of a constipated child. Sometimes after asking the about the last time they defecate, he/she might tell you two weeks ago. 

Signs of urinary tract infection can occur. This include passing bloody urine, painful urination, or passing little urine and fever. 

The child might also exhibit what is referred to as 'the doo-doo dancing'. This isn't common but it can occur. It involves the child jumping around, back peddling on tiptoes, moving few steps to the left and right. 

Misconceptions about constipation are common among patients

It is important, therefore, to establish exactly what patients mean when they complain of constipation. 
Hard, small or dry stools, bloating, abdominal cramps and discomfort, straining or grunting, sensation of blockade, fatigue, headache and nausea and vomiting. 
Passage of very hard faeces may cause anal tears.

Foods containing Fiber: encourage your child to take food containing fiber as this will help alot. 

Exercise: Regular physical exercise can help a child have a normal bowel movement. 

Drink more water: It is advisable to drink enough water as this is I'll help add moisture to the stool. 

Visit the toilet when in need: Encourage your child to visit the toilet when he/should  feels the urge to do so. 

Check the medicines: Consult your pharmacist for a medication review. Perhaps one of the child's medicines is responsible. 


Below are few remedies your health care provider might recommend. 

Bulk forming agents: this include substances like bran, isphagula, methylcellulose, psyllium, sterculia and polycarbopil. These agents have properties similar to dietary fibres and are usually taken as granules, powders or tablets. Their use is most appropriate in situation where dietary intake of fibre cannot be increased. Their effects usually take 12 to 36 hours (or longer). 

Patients should be advised to take ample fluids to avoid intestinal obstruction. 
Problems associated with their use are similar to those of dietary fibres. They include flatulence, bloating and distension.
Bulk forming agents are not recommended in patients with colonic atony, intestinal obstruction or faecal impaction, because they add to bulk and may aggravate the situation. 

Stimulant laxatives:

bisacodyl, senna and dantron. These drugs act by stimulating the mucosal nerve plexus of the colon, reduce transit time and result in the passage of stool within 8 to 12 hours. 
They are not recommended for regular daily use but can be used intermittently (every few weeks). 
bisacodyl can be used (intermittently) to cleanse the bowel before diagnostic procedures. 
Common side effect with their use is abdominal cramps. 
Other side effects include electrolyte disturbances and atonic colon (on long term use).
should not be used in patients with intestinal obstruction.

Osmotic laxatives: 

magnesium salts, lactulose, lactitol, sorbitol, polyethylene glycol, phosphate enemas and sodium citrate enemas
These drugs act by creating an osmotic effect whereby fluid is retained in the colon, thus producing softer, bulkier stool. Patients should be advised to maintain adequate fluid intake

Faecal softeners/emollient laxatives:

Example include docusate sodium.
These are surfactant agents that work by facilitating mixing of aqueous and fatty materials within the intestinal tract. 
They increase the penetration of intestinal fluids into the faecal mass resulting in softening of stools within 1 to 3 days of therapy 
They are ineffective in treating constipation but may be useful in lubricating and softening a hard faecal mass, especially if defaecation is painful due to haemarrhoids or anal tears. 

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