Clay-like stool in child’s underwear, which indicates rectum clogged with stool
Blood in stool
Avoiding bowel movement to escape from associated pain and discomfort
Visible signs of distress in your child include crossing legs, clenching buttocks, or facial expressions that indicate discomfort
When to see a doctor?
Most cases of constipation in children are simple and may not require special medical care. But take care not to miss the warning signs as they can lead to complications or may be indicative of an underlying condition.
Visit your child’s doctor if the symptoms including the following, last for more than two weeks:
Rectal wall sticking out of the anus (rectal prolapse)
Slower than normal movement of stool along the intestinal tract is the most common cause of constipation in children, which causes the stool to become hard and dry.
Some contributing factors for constipation in children are:
Suppressing the urge to pass stool
Your child may hold and avoid toilets as s/he may be too busy playing or prefer not to use public toilets. Sometimes, your child may refrain from having a bowel movement to avoid the pain during the process.
Early toilet training
Introducing your baby to toilet too soon can seed feeling of rebel in your child. The condition deteriorates further when voluntary withholding turns into a habit.
Lack of fiber in your child’s diet or not enough fluid intake can cause constipation. Often, the problems of constipation may come up while your child starts taking solid foods.
Changes in normal routine
When you child is exposed to a condition that’s not normal such as travel, hot weather or stress, s/he may observe changes in bowel function. For most children, the first day at school is constipating.
Medications that alter intestinal movement such as certain antidepressants and other drugs can cause constipation.
Children who are allergic to milk or those consuming a large amount of dairy products may also develop constipation.
Having a family member with constipation may cause your children to have the same possibly due to common genetic or environmental factors.
Constipation in children could occur secondary to underlying anatomic malformation, a metabolic or digestive system problem, or others.
4 Making a Diagnosis
Making a diagnosis of constipation in children is done by performing several tests and procedures.
Visit your child's doctor if symptoms last for more than two weeks. S/he may refer your child to a specialist in digestive disorders (gastroenterologist).
How to prepare yourself for the visit?
Getting prepared for the visit can optimize the therapy and help make the visit more fruitful. List out all the symptoms including changes in bowel habit, stool consistency and frequency.
Write down your key medical information. Write down the names of all your medications, vitamins or supplements.
Make a list of the questions to ask your doctor
Some typical questions can be:
What could be probable causes of my child's symptoms?
What kinds of tests are needed?
Is my child’s condition long lasting?
What are treatment options?
Does my baby need any dietary changes?
Should we see a specialist?
Is this condition treatable without medication?
What your doctor wants to know?
A clear talk with your doctor can optimize the therapy and improve the outcomes. Prepare yourself to answer some essential questions from your child’s doctor.
Your doctor might ask you typical questions like:
When did the symptoms start appearing and do they occur continuously or occasionally?
How severe are the symptoms?
Does anything improve or aggravate your child's symptoms?
Have you noticed blood in your child's stools, in the toilet water or on the toilet paper?
Does your child strain while evacuating bowel?
Is there a family history of digestive problems?
Has your child been given any new medications?
How do you describe your child's toilet-training experience?
What you can do in the meantime?
Here are some tips that you can apply while waiting for the doctor's appointment:
Increase your child’s fluid intake: You may give prune juice mixed with other juices. Make sure you child drinks sufficient water.
Limit intake of foods that may cause constipation such as milk and cheese.
Involve your child in regular physical activity, you could take for a morning walk.
Arrange some easy toilet training to see if strict toilet training is behind your child’s condition.
The diagnosis process includes
Medical history evaluation
Your child's doctor will have thorough look at all the available information on your child’s condition which might include past illnesses, diet and physical activity patterns.
It involves detecting the presence of impacted stool inside the rectum.
It involves test to detect blood in the stool. Following tests may also be carried out:
Abdominal X-ray shows obstructions in your child's abdomen.
Anorectal manometry or motility test
This test assesses coordination of the muscles during bowel evacuation in your child.
Barium enema X-ray
It involves X-ray of the rectum, colon and part of the small intestine by using barium to make the X-ray images more clear.
A small sample of tissue is removed from the lining of the rectum and sent for laboratory analysis.
Transit study or marker study
This test monitors the movements of a capsule containing X-ray sensitive markers along your child's gastrointestinal tract. The monitoring continues for several days.
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