Coping with Constipation

Treating constipation

Potty humor is all fun and jest – until an issue like constipation strikes. It doesn’t take long to realize there is nothing funny about the situation, which happens to all of us at one time or another. For children and their caretakers, especially, it can be frustrating.

Unpleasant as it can be, there are ways to get through an episode of constipation, says Prasanna Kapavarapu, MD, an attending physician with the Division of Gastroenterology, Hepatology and Nutrition at Children’s Hospital of Philadelphia.

Citing evidence-based data, Dr. Kapavarapu recently answered common questions about constipation. He also offered some new and age-old tips for treating it.

What are common symptoms of constipation?

Going a day or two without a bowel movement is usually normal and not cause for alarm, but evidence-based data indicates your child may be constipated if:

• They experience at least one episode of incontinence per week after acquiring toilet-training skills.
• Two or fewer stools per week in a child of developmental age of at least 4 years
• Their bowel movements are hard or painful, or the stools do not pass easily.
• They feel the need to have a bowel movement but are unable to do so.
• They have a history of passing stools large in diameter, to the point that for those potty trained, the stools clog the toilet.

What are common causes of constipation?

While constipation is rarely caused by a major medical issue, children become constipated for all sorts of reasons. Your child may become constipated if:

• They do not eat enough high-fiber foods, such as fruits and vegetables.
• They drink or eat too many dairy products.
• They repeatedly wait too long to go to the bathroom.
• They do not drink enough non-diary fluids.

Dr. Kapavarapu reminds that for a variety of reasons, constipation can also have an emotional cause. “Stressful transitions or changes in routines, such as starting a new school or issues at home or with friends, can bring on constipation,” he says.

How can constipation be treated?

While constipation can usually be treated at home with high-fiber foods and lots of fluids, Dr. Kapavarapu cautions against the use of any suppositories, laxatives or enemas without first consulting your child’s doctor or nurse practitioner.

But when deciding on a home treatment, he says the child’s age should always be considered.

For children younger than 4 months old, he suggests this mixture:

• 1 ounce of prune juice in 1 ounce of water, one or two times a day

For children 4 months to 1 year, he suggests feeding them the following:

• High-fiber baby foods, such as cereals, fruits (especially prunes), vegetables, spinach and peas.
• Fruits like prune, pear or apple and if needed the juice forms of these fruits are helpful. Dr. Kapavarapu says he’s heard from families who’ve had positive results with all three.

For children 1 year or older, he suggests the following:

• Feed the child raw, unpeeled vegetables and fruits (peaches, apples and pears) at least three times a day.
• Increase the bran in the child’s diet with graham crackers, bran cereal, oatmeal and whole-wheat bread.
• Decrease the child’s intake of dairy products, and increase their intake of water.
• Sit the child on the toilet for 10 minutes after meals, especially after breakfast or dinner, to encourage a regular bowel pattern.

When should you call the doctor?

While home treatments work most of the time, Dr. Kapavarapu says if the situation lingers, contact your child’s physician or nurse practitioner to consider alternatives. At the same time, be keenly aware of issues that require immediate medical attention.

Those emergency situations include when a child:

• Experiences severe pain with bowel movements
• Passes blood in their stool
• Develops tears in the rectal area
• Has not had a bowel movement in five days