Constipation in Children : Treatment of Constipation

constipation in children

Constipation in children is another distressing but very common problem encountered by parents

What is Constipation?

Constipation is defined as difficulty in the passage of stool that has been present for more than 2 weeks. Constipation is a common concern in the pediatric age group, both infants and older children.

There are 2 types of constipation in children. “Functional constipation” is the type where in a child voluntarily withholds the passage of stool. Holding back of fecal matter is usually caused the child’s fear of pain.
One reason why children experience painful bowel movement is milk protein allergy which excoriates the rectal mucosa, making the passage of normal bowel quite painful. Another type of constipation is “organic constipation” which generally involves some anatomical malformation in the intestinal area.
It is very important that these 2 types of constipation should be differentiated based on the child’s history and physical examination. The findings of underlying pathology which leads to the suspicion of an “organic constipation is the presence of weight loss, abdominal pain, or vomiting.

What is the treatment for constipation in children?

The therapy for functional constipation mainly involves parent and patient education. Relief of the fecal impaction is important and giving stool softeners would also help. The parents should establish a regular bowel habit for their children by making them sit on the toilet for 5-10minutes after every meal.

Bowel enema is often helpful for immediate relief of the impaction and stool softeners should be given as maintenance medications. Typical regimens that are prescribed by doctors include the use of mineral oil, or lactulose. The prolonged use of rectal stimulants to induce passage of stool should be avoided and is not advisable and should only be temporary measures for immediate relief.

Functional constipation in children is often caused by an insufficient intake of food or fluid. A proper and well balanced diet should be maintained to avoid constipation in children. Constipation may result in a very high fat or protein diet or in eating habit that is deficient in bulk. Children should be given enough amount of vegetables, fruits and cereals.

The presence of an organic pathology in a child with constipation requires more thorough work up in order to establish the diagnosis. A spinal disorder is one of common cause of constipation. The presence of hair tuft over the spine of a spinal dimple is suggestive of a spinal defect which should be investigated. Another common cause of organic constipation that is often found in infants is Hirshsprungs disease which involves a structural abnormality in the bowel mucosa.

 

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