Shri Ram Hospital

Constipation no doubt affects people of all age groups, but any ailment that becomes chronic should never be ignored. When it occurs in children, negligence can impact their overall well-being, development, and future health.

Chronic Constipation in Children

It is one of the most common gastrointestinal problems in children, which affects their daily life in terms of their appetite, headache, comfort, and overall well-being.

Though occasional constipation is not that serious, chronic constipation happens when a child experiences strain while passing stools for some weeks or longer. Parents should always keep asking their kids on a daily basis whether they have been feeling comfortable while passing stools. Early identification and appropriate management are crucial to prevent further difficulties.

1. What is Chronic Constipation?

It refers to persistent trouble in passing stools, generally lasting 2 weeks or longer. It comprises one or more of the factors mentioned below:

• Large-sized, hard, dry stools
• Infrequent bowel movements (less than 3–4 per week)
• Feeling of pain or strain during bowel movements
• Sensation of partial evacuation

It is observed that children who suffer from this kind of problem generally avoid going to the toilet due to fear of pain or discomfort, which further worsens the condition.

2. Occurrence and Importance

Studies say that up to 30 percent of children in the world suffer from chronic constipation, as it is one of the most common digestive ailments in children.

If not taken seriously, it can lead to further complications such as:

• Anal fissures
• Fecal impaction or fecal incontinence

3. Reasons behind Chronic Constipation

In most cases, about 95 percent, there is no serious underlying disease. The small factors that contribute to this condition are:

A. Nutritional Grounds

• Low intake of fibre
• Insufficient water intake
• Excessive consumption of junk foods like pizza, maida-based foods, momos, bread, burgers, Maggi, etc.
• Higher consumption of milk with less fibrous food; it generally affects babies who depend mainly on milk

B. Behavioural Grounds

• Disregarding the urge to pass stool
• Fear of discomfort during stool passing
• Lack of regular bathroom habits

C. Lifestyle Factors

• Almost zero or total absence of physical activity
• Irregular eating habits
• Spending excessive time on screens

D. Medical Causes

• Celiac disease
• Hirschsprung disease
• Hypothyroidism

4. Symptoms of Chronic Constipation

The signs and symptoms of this problem may differ depending on the age of the child and the severity of the condition.

Common indications include:

• Hard, dry, or large stools
• Lots of pressure required to pass stool
• Discomfort during bowel movements
• Fewer bowel movements
• Feeling of incomplete evacuation
• Stomach ache
• Loss of appetite
• Anal fissures may cause blood drops in stool

5. Other Factors

It is seen that chronic constipation develops in some children due to these factors as well:

• Poor eating habits
• Stressful toilet training
• Changes in routine due to travelling or school, etc.
• Genetics: Past history of chronic constipation in family members
• Anxiety or stress

6. Finding

Diagnosis of chronic constipation is typically based on physical examination and medical history. The doctor may enquire about:

• Consistency and texture of stools
• Child’s eating habits and water consumption
• Toilet habits
• Feeling of pain or discomfort during defecation

In some situations, doctors may advise:

• X-ray of the abdominal region
• Some blood tests
• Thyroid function tests
• Some advanced and specific tests for bowel function

With the overall analysis, the doctor can identify the root cause of chronic constipation.

7. Treatment and Management

Basically, in this problem, symptoms need to be relieved and regular stool passing habits should be established.

A. Changes in Eating Habits

The best remedy for constipation is always increasing fibre intake.

For this, the recommended foods are:

• Whole grains
• Fruits like mango, papaya, guava
• Green leafy vegetables
• Sprouts
• Eating daliya and chane

Water consumption should be increased, especially warm water.

B. Launching Healthy Toilet Behaviours

Now it becomes the duty of the parents to develop a proper toilet routine.

• Whether the child feels the urge to defecate or not, the child should go to the washroom three times daily and sit on the potty seat for 7–10 minutes.
• It will also be good if the child receives praise for attempting to pass stool.

C. Physical Activities

Activities such as running, playing outdoors, jumping, cycling, walking, and sports can help improve digestive function.

D. Medicines

The use of some medicines like homeopathic, ayurvedic, or allopathic also helps to overcome this situation. Doctors usually recommend medications such as laxatives and stool softeners.

8. Doctor Visit Becomes Crucial If

Parents should refer to a qualified doctor or gastroenterologist if:

• Severe abdominal pain is felt by the child
• Bloody stool is observed
• Constipation lasts for more than one or two weeks
• The child becomes underweight

Conclusion

Parents play a significant role in guiding kids towards healthy toilet habits. Healthy eating habits and lifestyle management play a major role in taking care of chronic constipation.