Constipation

Encyclopedia of Childhood and Adolescence

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Constipation, a condition that can affect the human digestive system at any stage of life, is rarely serious or chronic. Because bowel functions vary from individual to individual, the individual's own normal pattern should be taken into consideration when constipation is suspected. For this reason, it is important for parents and caregivers to be familiar with the bowel patterns of their infants and young children. Although constipation may cause considerable discomfort, a return to normal bowel function is usually accomplished within a day or two.

Constipation is caused when the muscles at the end of the large intestine restrict the fecal material from passing through and out of the body. A tendency toward constipation seems to be hereditary. The longer the fecal material is "stalled" in the large intestine, the drier it becomes, making it more difficult and even painful to pass. For children, the discomfort associated with passing a dry stool may cause them to avoid the process, thereby exacerbating the problem.

Infants

With young infants, constipation is rare, and it is not typically experienced until the infant begins solid foods. In an infant whose diet includes solid foods, constipation may be suspected if at least one bowel movement is not produced each day, or if the stool seems unusually firm or dry. An infant experiencing repeated or chronic bouts of constipation should be seen by a pediatrician, who can assess whether a digestive disorder is the cause. Constipation in breastfed babies is uncommon and almost always related to something other than diet.

One possible cause of constipation in infants under the age of one year is the switch from formula to cow's milk. Cow's milk is more likely than formula to cause constipation, and temporarily switching back to formula may alleviate the constipation. If the infant has started solid foods, an increase in dietary fiber may relieve the infant. High-fiber foods suitable for infants include prunes, apricots, plums, peas, beans, and broccoli. Cutting back on bananas and rice, both of which contribute to constipation, may also help.

Toddlers

When a child begins toilet training , it is important to establish regular, healthy bowel habits. Parents and caregivers should monitor the child's bowel function, which should include at least one bowel movement each day. If the child's bowel movements are infrequent, high-fiber foods, such as prunes, apricots, peas, beans, broccoli, and whole-grain breads, should be added to his diet. Increasing fluids, particularly water, may also help.

Retention of stool may become a problem between the ages of two and five. A child may avoid moving his bowels on the toilet during toilet training. By the next day, the retained stool is harder, drier, and therefore painful to pass. This discomfort encourages the child to avoid having bowel movements, and a cycle is established. Laxatives, stool softeners, and enemas should not be administered without consulting a pediatrician. Treatment for this type of chronic constipation includes a healthy diet high in fiber, with the possible addition of mineral oil until the child's system functions normally and without discomfort. A pediatrician will design a strategy to help cope with the preschool child's constipation.

School-age children

School-age children may experience problems having bowel movements away from home. As with infants and toddlers, school-age children who withhold bowel movements will have harder and drier stool. In some cases, the fecal material accumulates, stretching the rectum and nullifying the normal urge to have a bowel movement. Sometimes watery fecal material leaks out, appearing like diarrhea on the child's underwear. A pediatrician's advice will be required in restoring the lower digestive tract to normal function. Reestablishing a regular bowel routine will be necessary to correct this most severe example of constipation.

Further Reading

For Your Information

Books

• Schaefer, Charles E. Childhood Encopresis and Enuresis: Causes and Therapy. Northvale, NJ: Jason Aronson, 1993.
• Schuster, Marvin. What Is Constipation? Washington, DC: National Digestive Diseases Information Clearinghouse, U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Arthritis, Diabetes, & Digestive and Kidney Diseases, 1986.

Gale Encyclopedia of Childhood & Adolescence. Gale Research, 1998.