Treatment of constipation in children

Very often a child can cry and suffer, seemingly without any apparent reason. Parents are worried, but cannot determine the cause. It turns out that it is constipation - the inability to get rid of feces, pain in the tummy, painful bowel movements. How to treat constipation in a child?

See a doctor in time

Young children and newborns with constipation should be carefully examined and evaluated by a pediatrician. Poor nutrition can lead to dehydration and constipation, so the doctor should carefully examine the eating habits when testing your child to ensure that he or she is gaining weight and not losing weight. This is important for diagnosing constipation in children.

It is important to remember that constipation occurs much less frequently in children who are exclusively breastfed than in those who are bottle-fed. Infrequent bowel movements do not mean that the child is constipated.

Start of treatment

The initial steps in treating a child for constipation usually involve giving extra fluids: water or fruit juice once or twice a day. General treatment for constipation is adding bottled syrups to the child's diet as recommended by the doctor.

Although this is not generally recommended due to the theoretical risk of botulism, switching from cow's milk to soy milk is also key to stopping constipation in its early stages.

Medicines that are used to treat children with constipation are usually limited to colace, maltsupex, lactulose, and glycerin suppositories can be used from time to time.

Treating childhood constipation through dietary changes

The ultimate goal of treating your child's constipation is to get your child's bowels moving and have soft stools and daily bowel movements.

One of the main ways to prevent and treat constipation is to change your child's diet. Constipation-focused nutrition is the need to eliminate foods that cause constipation, including cow's milk, bananas, yogurt, cheese, cooked carrots, and other low-fiber foods. For children who drink a lot of milk, soy milk is a good alternative to cow's milk, and is usually much less constipating than cow's milk.

Another important dietary change is increasing the amount of fiber in your child's diet. How much fiber does your child need? The guidelines for fiber intake are that children should get 2-3 grams of fiber for each year of age each day. For example, 4-year-olds should consume at least 9-10 grams of fiber per day.

How to choose high fiber foods?

It would be very helpful for parents to learn how to read food labels to choose foods that are high in fiber. Fruits and vegetables, especially if they are raw and unprocessed, are a very good choice. It is important to eat vegetables that are high in fiber, and legumes, especially baked ones, go well with them, as do kidneys, lima beans, potatoes, peas, turnips, greens, and raw tomatoes.

Other foods that are good for children with constipation include vegetable soups (they have a lot of fiber with added liquid) and popcorn. The extra bran in popcorn can be helpful, as can cereals, bran muffins, shredded wheat, crackers, and whole wheat bread.

It is also important to increase the amount of fluid your child drinks daily. He should drink at least 2-3 glasses of water or fruit juice every day. Apple juice, pear juice, prune juice, or other juices are good choices.

Medicines for the treatment of constipation in children

Dietary changes to your child's menu will take time to become effective in the body, and until that happens, your child will probably need to switch to laxatives. These medications are often used long-term as maintenance therapy and are considered safe, effective, and non-habit forming.

If you want to avoid chronic use of stimulants, laxatives, your child can take castor oil for now on the advice of a doctor. It is generally safe for long-term use to soften stools.

Typical medications to relieve constipation in a child include:

• Milk of magnesia: contains sodium magnesiuim, an osmotic laxative, although it is not suitable for all children.
• Malt extract: or Maltsupex, it has an unpleasant odor but is easily used to treat constipation in younger children.
• Medicines for children based on the substance simethicone (used as a laxative) - espumisan or simplex, for example.
• Dill water (boiled dill or pharmaceutical product)
• Suppositories with a laxative effect
• Lactulose: Used as a laxative (available with prescription)

Timing of taking medications

Keeping in mind the main goal of treating your child's constipation - soft stools every day - you may need to take medications for a long period of time, up to 4-6 months. One of the biggest mistakes parents make is stopping their child's treatment once their stools are normal. If you do this too soon, your child will be prone to relapse and constipation will return again.

Instead of stopping the medication as soon as your child's bowel movements are normal, the dose should be reduced by 25%. So, if your child was taking 1 teaspoon of milk of magnesia, you should reduce the dose to 3/4 teaspoon. Don't make too many changes based on your own findings; consult your pediatrician first.

Once your child is going to the toilet regularly and has soft stools, you can talk to your pediatrician about reducing the dosage of the laxative you are using. This is usually done gradually, often by decreasing the dose by 25% every 1-2 months. Stopping the laxative too quickly may cause your child to complain of painful bowel movements again. It is also important to continue your child's diet while taking the laxative and after your child stops taking it.

Treatment of acute constipation in a child

If the child has very hard stool and cannot go to the toilet, his bowel movements are painful, special treatment will be required. First of all, it will be necessary to cleanse the child's intestines from feces, and then use a diet and laxatives, if they have not worked so far.

Fortunately, cleansing the rectum is rarely done manually. It is usually done with an enema or suppository. It can also sometimes be done using high doses of mineral oil - often 1 ounce (28.3 grams) to 8 ounces (226.8 grams) for 2-3 days.

Children under one and a half years old can be given glycerin suppositories. Children from one and a half to 9 years old can be given enemas or 1/2 suppository of Dulcolax (they improve intestinal peristalsis and act as a laxative). For older children, a whole suppository of Dulcolax can be used.

You should avoid using enemas or suppositories regularly. They are sometimes needed as an emergency treatment – but only if your child has not had a bowel movement on his own for 3-4 days. And if you need to use these regularly, you will most likely need to increase the dosage and maintain the therapy.

Correcting a child's behavior in the fight against constipation

Once your child's stools are soft and regular, it is important to modify and encourage behaviors so that your child continues to have regular bowel movements. This often involves having your child sit on the toilet for about 10 minutes after eating once or twice a day. You can keep a diary or chart of when your child has bowel movements and/or takes laxative medications, and then praise and reward your child for good behavior.

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Complications of constipation in a child

In addition to pain, constipation can lead to anal fissures or tears in the skin around the rectum, bleeding, hemorrhoids, and rectal prolapse. Encopresis (fecal incontinence) is another complication of chronic constipation and can lead to forced leakage of stool.

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Prevention of constipation in children

Foods and drinks that may prevent constipation include the following

• lots of fresh vegetables and fruits that the child eats washed but not peeled, including apples, grapes, peaches, etc. lots of fresh fruits with a high water content, such as watermelon and cantaloupe
• raw vegetables
• legumes (beans)
• raisin
• prunes and figs
• products made from whole grains (whole wheat bread, etc.) shredded wheat or sprouted wheat
• bran cereals and bran buns
• vegetable soup

Useful Insights About Constipation

Although constipation in children is often a chronic condition that is difficult to treat, it is something to learn to live with and manage at the same time. Over time, with proper nutrition and medical intervention, your child should be able to establish regular bowel movements and stools.

If your pediatrician is unable or unwilling to help treat your child for constipation, it may be worth seeking additional help from a pediatric gastroenterologist. A referral to a physical therapist or massage therapist is also a good idea if your child shows any signs of a more serious constipation condition or if current treatments are not working effectively.