Going to the bathroom is something people do many times a day. And usually, we don't have to think about it.
For a child with constipation, however, bathroom trips can be painful, frustrating, stressful, scary or even embarrassing.
When children experience these issues, they are considered to be constipated:
Constipation may also cause the child to feel bloated or experience sharp — sometimes severe — pain around the belly button.
Pediatric gastroenterologist Anil Kesavan, MD, and pelvic floor physical therapist Trish Mesch, PT, are among the specialists at Rush who work with children and their parents to address constipation. Here, they offer 5 tips to help overcome this common problem.
It's no secret that fiber — found in fresh fruits and vegetables, and whole grains — helps keep the bowels running smoothly. But many kids simply aren't getting enough, Kesavan says. Combine that with a diet high in fats and processed sugars, and you’ve got a recipe for constipation.
How much fiber do kids need? About 14 grams daily for every 1,000 calories they eat, which translates to the following:
Bumping up the fiber in your child's diet doesn't have to mean boring meals and snacks. These kid favorites are also tasty sources of fiber:
Water helps keep stool soft, so it moves more smoothly through the intestines. If you're not getting enough water, stool can become harder, which can lead to constipation.
Make sure your kids drink three to four 8-oz. glasses of water each day. If possible, Mesch says, send a full water bottle to school with them so they can stay hydrated throughout the day. If your child's school doesn't allow water bottles, pack one for lunch instead of a juice box or pouch.
Then, serve a big glass of water at dinner. Trading juice for water once or twice a day will also help to reduce your child's daily sugar intake.
A bowel at rest tends to stay at rest. The best way to get the bowel moving is to move around.
There are lots of ways to help your kids be more active. Sign them up for a sports or dance class. Shoot some hoops with them. Take them bowling or mini-golfing. Go for a family hike or bike ride. You'll all reap the health benefits — and have fun.
After meals, your digestive system is already moving along, so it's a good time for kids to try having a bowel movement.
Constipation sometimes has a behavioral component. For instance, kids can get in the habit of "holding it in" when they feel the urge to have a bowel movement.
"We see this a lot in school-aged kids," Kesavan says. "Nobody likes to have bowel movements in school. They may feel embarrassed to do it around their classmates, or they're worried they won't have time to sit on the toilet long enough between classes. So they end up holding it in for the entire school day."
However, this can cause the stool to become firmer and more difficult to pass. And fear of a painful bowel movement may then make kids even more reluctant to go. "Sometimes, all it takes is one bad experience to start a vicious cycle," Mesch says.
To help break the cycle, try "toilet time." Have the child sit on the toilet twice a day — after breakfast and after dinner — for 10 to 15 minutes each time. Just be aware that you may need to build in extra time before school so your child doesn’t feel rushed or stressed.
"After meals, your digestive system is already moving along, so it's a good time for kids to try having a bowel movement," Kesavan says. "If they go, great. If not, that's OK, too. But you want them to get back in the habit of going to the bathroom regularly."
Pediatric pelvic floor physical therapists like Mesch address the physical, behavioral and emotional causes of constipation in kids. In addition to educating parents and children on diet and hydration, they offer a variety of therapeutic approaches, including the following:
"Our goal is to get the child's bowel function back to normal, which means how it was before the constipation started," says Kesavan. "Sometimes, changing the child's diet a little can help. But for more severe constipation or if there is a behavioral component, you may have to try a combination of approaches before you see results."
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