Constipation

What is constipation?

Every child has different toilet habits. Some may go 2-3 times a day; others go only once a week. Constipation only occurs when stool become hard and/or very large. Constipation is not about frequency; it’s about the difficulty in passing stools.

Things your child may complain of with constipation

  1. ‘My tummy hurts’ Stomach pains from constipation may come and go.
  2. 'It hurts on the toilet’ Pooing may be painful which means your child might not want to go to the toilet. This delay makes stool in the bowel even harder to pass.
  3. ‘I’ve got a runny bottom’ Diarrhoea may result because the only way ‘new’ stool can get past the hard mass of faeces blocking in the bowel is to become watery.
  4. ‘I’ve pooed my pants’ Soiling can occur when the bowel wall gets stretched by the presence of large mass of faeces. This can lead to loss of feeling in the nerves of the bowel walls so your child doesn’t realise they need the toilet.
  5. ‘I’m not hungry’ A poor appetite can result from feeling vaguely unwell.

What happens to the bowel during constipation?

As hard stool builds up it stretches the bowel larger than normal. The stretched muscles of the bowel wall can’t then function properly to clear the bowel. If the bowel is not emptied, the muscles can’t regain their regular strength and so constipation continues.

What to do?

First the hard mass of faeces must be passed. This may mean using softening agents, enemas and suppositories. Then the bowel must be kept empty. This is so the bowel has time to recover its normal muscle function. It’s important that faeces do not build up again until the bowel is functioning normally. To keep the bowel empty use a liquid lubricant laxative such as Children’s Parachoc®.

About Encopresis

Encopresis is the inability to fully control the bowel, resulting in a soiling accident. This can occur in underpants and sometimes in the bath or pyjamas. It’s quite common - one child in every two or three primary school classes might have soiling difficulties.

What happens?

When the bowel can’t clear stool normally it builds up in the large intestine. As the large intestine or rectum stretches it decreases the sensation of stool presence. With a child unaware they need to have a poo, the retained stool may leak out and a soiling accident happens.

What causes it?

There are several causes including the following.

  1. A lack of muscle co-ordination in the lower bowel (rectum) and anus. This makes full and effective evacuation of faeces difficult.
  2. A lack of sensitivity or feeling in the rectum so a child can’t tell they need to have a poo. This leads to a build up of stool which can then leak out.
  3. Some children are afraid of pooing because it hurt during past episodes of constipation. They may resist the urge to go to the toilet leading to stool build up.

How can you help?

A programme of regular sits on the toilet along with the help of a stool softener such as Children’s Parachoc may help your child. It helps to empty the large intestine and establish and maintain regular bowel movements. A healthy diet with adequate fibre (from cereal, fruit and vegetables) and drinking plenty of water or fruit juice will help.

If you would like a copy of Children's Parachoc Diary which includes a training diary and information on constipation and encopresis please contact us.

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