What to Do If Your Child Cannot Poop

When kids turn a simple walk in the toilet into a marathon, the question shouldn’t be just, “What are they doing there?” but “What are they not doing?”

This is the case when my wife and I first encountered our 7-year-old daughter two years ago. We noticed that she was a little lethargic and spent extra time in the bathroom after school or weekend afternoons. None of us gave it much thought until we went to do the laundry and found a pile of little girls’ underwear that was attacked by Nature’s brown pencil. It turns out part of her long trips to our shared bathroom on the second floor was to change into clean underwear.

She was embarrassed to tell us what was going on. She couldn’t remember the last time she pooped, and she refused now because pushing was too painful. “This is awful,” she told us and refused to go to the bathroom. We called a pediatric gastroenterologist about celiac disease, an autoimmune disease caused by the use of gluten. He recommended that we give her a dose of Miralax, a brand of polyethylene glycol laxative with stool softener, and orange juice similar to the one we would take before a colonoscopy.

Five hours later, she was emptied in what my wife described as the most disgusting bodily function she has ever seen (impressive feat as we’ve been together as a couple since the mid-1990s). Unfortunately, this was not the last time it happened. Every nine months or so, my daughter talked about “dirty poop” and went through tons of underwear.

Constipation is rarely thought of in the context of children, primarily because it is not viewed as a problem. Celiac disease and an extremely picky diet exacerbate my daughter’s problems, but constipation is not limited to children with medical conditions. In fact, this is more common than you might think.

“Many bowel disorders can be corrected by ensuring adequate intake of water and foods high in both soluble and insoluble fiber,” said Dr. Anna-Marie Simpson, a clinical nutritionist and chiropractor based in Syracuse, New York. with an assortment of fruits, vegetables, lean proteins and healthy fats is vital to a healthy gastrointestinal system. “

What causes constipation?

The list of possible causes for Simpson begins at birth: babies after a caesarean section miss the compression of the birth canal, which stimulates the child’s intestinal motility; Naturally born babies absorb the mother’s bacterial flora , which contributes to the development of the baby’s intestinal bacteria ; breastfed babies receive pre- and probiotics from the mother that are not in the formula.

(My daughter was born as a result of an emergency caesarean section and we started formula feeding in the second week of her pregnancy for other reasons. The above information is not overlooked.)

She points to food as the most important factor. Food does not contain the same level of nutrients as before. According to a University of Texas study, she points to carrots that are lower in protein, calcium and iron today than they were in the 1950s . Known for being rich in vitamins and minerals, spinach today contains fewer vitamins A, B-1, B-2, and C than before.

“The food we eat not only fails to meet the basic nutritional requirements for our body to grow, but it also creates ‘stress’ on our systems,” Simpson said. “These stresses have led to an exponential increase in bowel disorders such as constipation in children, in addition to increased food sensitivities, intolerances and allergies.”

Ultimately, giving up pooping is a behavioral decision, according to Dr. Matthew Di Guglielmo of the Department of Gastroenterology / Hepatology / Nutrition at Nemours / Alfred I. DuPont Children’s Hospital in Wilmington, Delaware.

“This behavior is self-reliant and not a resistance to someone’s efforts to treat or help,” Di Guglielmo said.

What happens with constipation?

Passing hard, dry, or hard feces through a relatively small opening in the anus is painful in itself. Di Guglielmo says irritation of the skin and urethra from the congestion can make the situation worse.

“Certain muscles are controlled voluntarily,” said Di Guglielmo. “When a child is anxious or afraid of a painful bowel movement, he or she can avoid it by refusing to relax or by using certain pelvic floor muscles and external anal sphincter muscles to trap the feces inside.”

The colon stretches to support it, but encopresis or fecal leakage may occur. The hardened feces act like a large rock in the middle of a stream, and fresh, softer feces flow around it, exiting the body.

Eliminating the problem

The short term is to clear the blockage, but the long term solution takes time. DiGuglielmo believes that many children need supportive medications, dietary changes and behavioral interventions to correct recurrent constipation.

Simpson shares this opinion.

“Talk to your doctor about the dosage, but omega-3s are a good start followed by a good prebiotic and probiotic,” she said. Digestive enzymes and other supplements can aid in healing.

Both Simpson and Di Guglielmo emphasize the importance of talking to a pediatrician when constipation occurs, but encourages a second opinion if warranted.

“People are happy that“ Dr. Google suggests, but ask your doctor questions, Simpson said. Trust your instincts and seek other opinions.

Not everyone needs to see a specialist, but if a pediatrician reacts to recurring or persistent constipation “over time it will go away” or “he / she will outgrow it,” he / she should consider a different opinion.

“Constipation is very common, and chronic constipation is often underdiagnosed and persistent in most, if not all, children,” Di Guglielmo said.

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