Childs & Constipation (Sembelit)

Constipation is when bowel movements become less frequent and difficult to pass.

How common is this in children and what contributes to it?

• It is a common problem in children but is usually temporary.
• Factors promoting constipation are :
o Inadequate fiber in diet
o Inadequate fluid intake
o Lack of exercise
o Resisting the urge to have a bowel movement
o Underlying illnesses eg Hirschprung disease or hypothyrodism
o Medications eg narcotic analgesic

How do I know if my child has constipation?

Signs and symptoms include :
• No bowel movement for days or passing stools that are hard and dry
• Cramping abdominal pain
• Painful defaecation process as manifested by clenching buttocks, rocking up and down on toes, and turning red in the face
• Faecal soiling (known as encopresis) of child's underwear

What problems can it cause?

• Small tears in anal area (known as anal fissures) which can bleed and causepain
• Refusal to have a bowel movement
• Social embarassment from faecal soiling
• Complications arising from underlying illnesses eg intestinal obstruction in Hirschprung disease

How is constipation in a child managed?

Evaluation

• Important to evaluate situation to exclude and treat underlying illnesses.

Medication

• If condition is serious, an enema to remove the stool and or oral laxative to soften it may be prescribed by the doctor as initial therapy.

Diet

• Increase fluid and fiber (found in fruits, vegetables and whole-grain cereals) in diet for older children.
• In young babies who are not yet on solids, ensuring adequate milk intake is important. A change of formula in formula fed babies may be considered after consultation with the doctor.

Exercise

• Getting more exercise may also be helpful.

Toilet retraining

• To reestablish a regular bathroom routine.

How is toilet retraining done?

• Child should sit on the toilet on a daily basis for at least 15 minutes
• During this time he can read a book or play a game
• Consistency, patience and persistence are necessary to succeed

How can this Constipation be prevented?

• High fiber and adequate fluids in diet
• Exercise
• Bowel habit training

What are the warning signs to be aware of?

Consult your doctor if :
• Episodes last more than 3 weeks
• Child is restricted in normal activities
• Anal fissures occur
• Small amount of intestinal lining protrudes through the anus (haemorrhoids)
• Inability to expel stool from anus
• Presence of encopresis

Source: http://www.myhealth.gov.my