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Constipation in Children is a Growing Problem


Experts at Johns Hopkins Children’s Center say constipation is a growing problem, and the trend is for more bouts of serious, chronic events. At the Center, physicians have seen a 30 percent increase in constipation related visits between 2008 and 2009.

Constipation in children is often untreated or treated poorly

According to Maria Oliva-Hemker, MD, director of pediatric Gastroenterology & Nutrition at Hopkins Children’s, “too many children are either not treated at all, start treatment too late or are treated inadequately, leading to persistent, severe and chronic constipation.” Some of the reasons for these problems with treatment are the belief that constipation will go away on its own, that dietary changes can fix it, or that children will outgrow it.

Most children have functional constipation, which, according to Oliva-Hemker, means it is not caused by a disease or a physical abnormality. Children with functional constipation have fewer than three bowel movements per week for any three months of the year.

While mild constipation typically is associated with a lack of physical exercise, poor water intake, and diets lacking in sufficient fiber, Oliva-Hemker warns that “severe constipation need to be treated early and aggressively,” and that giving children fiber and prune juice will not correct chronic cases.

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Signs and symptoms of constipation in children include abdominal bloating, a feeling of fullness, lumpy or hard stools and/or pellet-like stools, straining with bowel movements, soiling of underwear, and bedwetting. Some children will refuse to go to the bathroom or hide. Children who are experiencing any of these signs or symptoms should be taken to their healthcare provider.

Parents should be aware of certain times of the year and circumstances that can trigger constipation or behavior that can lead to it. These include toilet training, starting school, travel, camping, viral illnesses, and dietary changes. Use of certain medications, such as antacids and antidepressants can contribute to constipation, and children who have diabetes, ADHD, or Down syndrome are more likely to develop the condition.

The recommended first-line of treatment for chronic constipation in children is over-the-counter osmotic products such as polyethylene glycol-electrolytes, which increase the amount of water in the colon. Although laxatives can be given to children, the National Institute of Diabetes and Digestive and Kidney Diseases recommends parents consult a physician before doing so.

Children with constipation can evolved into adults with the same problem, and the condition can worsen over time. To help prevent constipation from occurring in the first place, parents can ensure their child drinks lots of water, is physically active every day, eats foods rich in fiber such as fruits and vegetables, avoids processed foods and foods high in sugar and fat, and knows he or she should not “hold” or ignore the urge to go to the bathroom.

Johns Hopkins Children’s Center
National Institute of Diabetes and Digestive and Kidney Diseases