Constipation, the number 2 blues

It should be something that happens naturally right? After all, we all do it ... it has to happen. So it’s understandable that when toileting goes horribly wrong, it can be really stressful for both parents and children – and not easy to talk about!

Constipation can be a real issue for many children. If your child goes four or more days without doing a poo, regularly has dirty pants or hard poos, or finds pooing painful, they may have constipation.

Ongoing constipation can lead to more serious conditions such as impaction. This is when the bowel is never emptied, and gets stretched by being constantly full of poo. This can affect the sensations or feelings in the bowel, so the child can no longer tell when they need to go to the toilet. It can impact on sensations in the bladder as well, leading to regular wetting. A child who has an impacted bowel cannot help soiling or wetting their pants – they are no longer getting the right signals to tell them to go.

Associated symptoms of constipation can include bad breath, nausea, fatigue, colicky pain, bloating, mucus around stools and headaches.

what is a normal poo?

A normal poo pattern can be different for different people – anything from 2-3 a day to 2-3 times a week. But as a general rule, your poo should be soft and easy to pass.

what causes constipation?

It may be that your child has had a painful poo and now has a ‘habit’ of holding on because they are afraid. Or it may be they are just too busy to stop and go to the toilet.

They may not drink enough water, or eat enough fibre. Food intolerances can also cause constipation.

Not enough exercise; a change in routine; stress or emotional upset; and some medications can also cause constipation.

how to fix constipation

The key thing is to establish better poo habits.

Set regular times for sitting on the toilet: first thing on waking, last thing before bed, and 15 minutes after each meal are good times. A reward chart can help with motivation. Start them with sitting for a few minutes and work up to 10 minutes.

Try and catch them ‘holding on’ and encourage them to sit on the loo instead. Signs are: pausing in their play; sitting down; hiding; or going red in the face.

Use a foot stool to elevate their knees while they sit.

Make the toilet fun, with posters on the walls and special books in a box beside the loo.

Encourage them to push by blowing bubbles, blowing up a balloon or playing their recorder while sitting on the loo.

Make sure your child drinks water regularly throughout the day. Add more fruit and vegetables into their diet. Try kiwifruit, pears, pineapple, prunes, broccoli and wholegrain foods.

If your child has an impacted or stretched bowel, they may be prescribed laxatives to clear them out. It may take a long time for the bowel to shrink back to its normal shape, so be prepared for this to take a long time to fix.

If you are struggling, visit your GP. You may get assigned a district nurse to help you with establishing habits and to give you support.

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