Health Awareness blog

Constipation is the infrequent passage of hard stools causing distress. In severe cases, it will lead to overflow staining of the underpants.

  How can constipation occur?

If your child ignores the urge to go to the toilet, the urge to defecate may lessen. The longer they wait, further water loss from the retained stool will occur. The retained stool will be even more difficult to pass. This can also lead to overflow staining on the underpants. Some parents might mistakenly think their children have diarrhea instead.

One thing to remember is parents should not overreact to mild constipation. It is very common in infancy. What you should do is you should be aware of your child bowel habit. Try to lessen ‘holding on’ behaviour. You should encourage a high fibre diet for all the family. They also should take plenty of fluids, particularly plain water and unsweetened fruit juices. Allow your child to set the pace in terms of toilet training. Do not set rigid age-related time scales for successful training. Encourage a sitting regime whereby your child sits for 10-15 minutes after school and after evening meal.

  What are the examples of high fibre diet?  

There are varieties of food that have high fibre, which is not only healthy, but also delicious. This is very important to encourage the child to eat.

• cereals such as weetabix
• porridge
• muesli
• wholegrain bread
• dried fruits such as sultanas, apricots and prunes
• fresh fruit with skin left
• brown rice
• whole meal pasta

  Dealing with overflow staining  

• Do not blame your child
• Stress to him or her that this is a common problem in childhood
• Consult your family doctor
• Your doctor will take full history and examine your child
• He/she will request an x-ray to confirm the presence of constipation
• Laxative therapy will be prescribed to soften the stools
• This therapy may needs to be continued for many months depend on the severity of the case
• You will be given advice about a high roughage diet

  Tips need to be remember  

• The most important aspect is to enthusiastically support your child to sit on the toilet about 10-15 minutes after each meal.
• The sitting regime needs to continue for at least 4-6 months until normal sensation in the lower bowel returns.
• With the support from parents, the vast majority of children will get better and staining will stop rapidly.
• Your child will usually need to continue seeing your doctor for up to 12 months after the initial visit.

  Summary  

Most chronic constipation will resolve after this simple treatment. However, there are some cases that may need further evaluation and management by your doctor. Please discuss with your doctor if this symptom recur or not improve after laxative therapy and toilet training.

Reference:

1. Oxford handbook of clinical specialist, 5^th edition.
2. Child health fact sheet, Dublin Children Hospital, Ireland.

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