How to tell... if your child is constipated

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How to tell... if your child is constipated
Constipation in children can occur from the newborn period to older children. It is a problem caused by abnormalities in the excretory system, which can be observed when a child has fewer than 3 bowel movements per week or has hard stools with blood, causing increased straining during defecation. If left untreated, it can affect the anus.

What are the main causes of constipation?

More than 90% of cases are caused by bowel habits. Children often hold in their stool, lack discipline in using the bathroom, or may have a diet low in fiber. Nowadays, fast food is easily accessible, so children tend not to eat vegetables and fruits. Additionally, drinking little water causes stools to harden, leading to constipation.

 

However, another cause may be abnormalities in the gastrointestinal tract from birth. Children may have intestinal abnormalities, a narrow or small anus, or a condition called Hirschsprung’s disease, where the large intestine lacks nerve cells, preventing proper bowel contractions to the anus. Symptoms usually appear from birth. It may also be caused by an underactive thyroid gland or the use of certain medications that cause constipation in children.

Signs of constipation when your child has infrequent bowel movements

It is easy to observe when your child has fewer than 2 bowel movements per week for more than 2 weeks. During defecation, the child may strain for a long time and sometimes experience bloating and abdominal fullness. If left untreated, the child may start to feel pain around the anus, possibly with cracks or swelling, and stools may contain blood. If the child strains to pass large, hard stools, it may cause anal fissures. When the anus is injured, the child may avoid using the bathroom, leading to chronic symptoms.

 

With chronic constipation, the child may exhibit strange behaviors such as trying to hold in stool, standing and straining, being afraid to sit on the toilet, tiptoeing, stiffening legs, and clenching the buttocks until pale and sweating. If you try to make the child sit to defecate, they may cry and resist. If this continues for a long time, more water will be absorbed from the stool, making it harder and larger, causing difficulty in passing. When the large intestine is stretched too much, the nerve system that senses the wall of the distal large intestine is damaged, reducing the sensation of stool and requiring a long time for treatment to return to normal.

When your child has chronic constipation…

When your child develops chronic constipation, you should take them to see a doctor for treatment. The doctor will first perform anorectal manometry to assess the function of the large intestine and anal sphincter to diagnose the cause of chronic constipation. If it is caused by a segment of the distal large intestine lacking nerve cells from birth, surgery is the only cure.

 

If chronic constipation is caused by improper straining, or by the anal sphincter muscle contracting and not relaxing, or by fecal incontinence due to abnormal muscle function controlling defecation, treatment involves training the muscles controlling defecation and normalizing sensation in the anus (Biofeedback therapy) to improve bowel movements and restore normal function.

Prevent your child from constipation starting at home

Did you know… breast milk is the best nutrition to help prevent constipation in your child? But when your child is over 6 months old, you can give fruit juice, vegetables, vegetable broth, and children over 2 years old can be trained to have bowel movements after breakfast every meal for 10-15 minutes and drink plenty of water after waking up to develop a habit. Also, provide plenty of fiber-rich vegetables and fruits such as ripe papaya, ripe banana, and oranges because fiber helps soften stools and makes bowel movements easier. Yogurt, honey, lemon juice, tamarind juice, and prune juice also help.

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