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CONSTIPATION

What is constipation?

A very common condition in children

where they have infrequent bowel movement or difficulty passing stools.

 

Causes of constipation in children

  • Not taking enough time to sit and try to pass stool on a routine basis

  • Painful experiences around stool passage

  • Withholding of stool as a result of past discomfort, fear of pain or not wanting to use the public toilet

  • Family history of slower bowel function

  • Diets that are too low in fibre

  • Not drinking enough fluids

  • Medications that are constipating

  • Having low muscle tone, neuromuscular problems, and/or developmental delay

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Management of childhood constipation

  • Position: use footstool, lean forward and put elbows on knees

  • Toilet sits: up to 5 minutes, 4-5 times a day, preferably after meals

  • Encourage a routine to sit on toilet. Ensure toileting remains a positive experience

  • Chart or diary to reinforce positive behaviour and record frequency of bowel actions

  • Physical activity: encourage children to exercise more to help stimulate the bowel

  • Review toilet access/investigate barriers to using school toilets

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Dietary modification

Increasing dietary fibre is often not sufficient for treatment of childhood constipation.

Excessive cow milk intake may exacerbate constipation in some children. 

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LAXATIVES

Osmotic and lubricant laxatives are usually required long term (months to years).

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