During potty training and beyond, parents of young children need to be on the lookout for chronic constipation.
That’s the message from Dr. Maria Oliva-Hemker, director of pediatric gastroenterology and nutrition at Johns Hopkins Children’s Center in Baltimore.
The center runs a multidisciplinary clinic offering medical and behavioral therapy for chronic constipation affecting children.
Doctors at the center are troubled by a possible rise in the more serious cases of pediatric constipation, not just the mild constipation that is normal in childhood.
They say the fault could lie with children’s lack of physical activity, inadequate water intake and diets too low in fiber.
Outside of children’s habits, there could be other factors leading to a rise in severe cases, including delays in diagnosis, Oliva-Hemker said.
“The reality is that too many children are either not treated at all, start treatment too late or are treated inadequately, leading to persistent, severe and chronic constipation,” Oliva-Hemker said in a Johns Hopkins media release.
A columnist for the Cleveland Plain Dealer recently researched severe constipation in kids and was told by pediatric gastroenterologists that 25 percent to 30 percent of young children struggle with constipation.
The columnist, Sarah Jane Tribble, noted that the condition can lead to emotional scars. On the other hand, psychological concerns such as fear of using the toilet can lead to severe constipation.
In the early stages of potty training their children, parents need to keep the experience positive and refrain from reprimands,Tribble learned.
Pediatric gastroenterologists that she interviewed said to be on the lookout for bowel movements that are pellet-like and/or bowel movements that occur less than twice a week.
Other signs that warrant a visit to the doctor’s office include straining with bowel movements, a feeling that the bowel is not empty, and behavior that indicates the child is resistant to “going number two.”
The first line of treatment for chronic constipation, the clinic said, is over-the-counter osmotic products like polyethylene glycol-electrolytes, sold in powder form.
They are not laxatives and are not habit-forming, but they do increase water in the colon to promote bowel movements. A doctor needs to monitor the dose and duration of the osmotic.
Preventive measures against childhood constipation include:
- Drinking plenty of water
- Limiting dairy products if they seem to make a difference in bathroom habits
- Staying physically active
- Favoring fruits and vegetables over foods high in fat and sugar, and processed foods
- Helping the child understand that “holding it in” or ignoring the urge to have a bowel movement makes the problem worse
“Severe constipation needs to be treated early and aggressively,” Oliva-Hemker says. “And no amount of fiber or prune juice will help a child with serious chronic constipation.”
In addition to seeking help from a pediatrician, parents might also want to consider an appointment with a pediatric gastroenterologist.
As the Healthy Children website of the American Academy of Pediatrics explains, pediatric gastroenterologists see children for conditions ranging from colon and liver health to abdominal pain to food intolerances.
If needed, they can perform a variety of endoscopic procedures and specialized colonoscopies, the website noted, adding that digestive, liver and nutritional problems in children are often quite different from those seen in adults.
Pediatric gastroenterologists treat infants, children and teens.
Tribble, Sarah Jane. “Chronic constipation easy to overlook, hurts children.” Cleveland Plain Dealer. Web. 22 October 2012.
“Plugged Up: Doctors See Signs of Worsening Constipation in Children.” Johns Hopkins Children’s Center. Web. 22 October 2012.
“What is a Pediatric Gastroenterologist?” HealthyChildren.org. Web. 22 October 2012.
Reviewed October 23, 2012
Michele Blacksberg RN
Edited by Jody Smith