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The Next Stage – Constipation – Nothing to Poo- Poo

Constipation is a common symptom in childhood and can be attributed to many different causes.  Constipation is defined as bowel movements that are less frequent and/or painful and difficult to pass.

For many children, constipation is a transient thing that happens from dietary change.  Eating foods that promote constipation such as junk food and not getting enough fibre or fluid in the diet may promote hard and less frequent stools.  As the stool becomes harder, it can cause pain to pass and lead to withholding. A vicious cycle begins where the withholding leads to harder stools. Harder stools may also lead to tiny tears or fissures at the anus.

Prolonged and recurrent constipation can also lead to fecal soiling known as encopresis.  This is a difficult problem to solve and may take months to retrain the bowels.

Transient constipation may respond to simply adding more fibre and fluid to the diet.  Encouraging your child to use more time on the toilet and making this a pleasant experience can help to relax the bowel and lessen the fear of a painful bowel movement.

Encopresis is often a sign of more serious constipation Medications to soften the stool may be required for a more prolonged period of time.

It is important to note that, even with “functional constipation” or constipation resulting from the withholding that leads to encopresis, it is not something that your child is doing wilfully.  Negative or punitive punishments only worsen the problem.

See your primary care provider if there is fever, increasing abdominal pain or any blood in the stool. Constipation is, indeed, nothing to poo- poo.

Dr. Bhooma Bhayana is a family physician in London and the mother of two young men and grandmother of one lovely princess! She continues to find wonder and enjoyment in family practice despite more than 30 years on the job!


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