Constipation

Different people have different bathroom habits. So someone who doesn’t have a bowel movement every day isn’t necessarily constipated. One person might go three times a day, while another might go once every 2–3 days.

So what is constipation exactly?  

Constipation is defined in many ways  on the basis of reduced frequency of passing stools, trouble when having a bowel movement  or/and  a change in the nature of stools (hard, dry, unusually small or  large). There may also be  a feeling of not having passed out all the stool. Constipation is a very common problem.

What causes Constipation?

1. An unhealthy diet may contribute to constipation. This includes:-

• Inadequate water intake
• Inadequate fibre intake
• Increased processes foods
• Increased meats and cheese

2. Inadequate exercise . ( moving around helps food move through the digestive system)
3. Stress or anxiety for prolonged periods like over long examinations. ( some people may also get diarrhoea instead)
4. Ignoring the natural urge to pass stools or avoiding the washroom. This is common among children who would rather continue playing, watching their favourite TV show or those afraid to use public or school toilets. This may also occur when they travel away from their familiar washroom e.g. over the holidays. The natural urge to pass stool is accompanied by a natural assistance from the normal intestinal muscles. When this urge  passes, it is more difficult to pass stool using only voluntary strain and the longer stools stay in  the harder they become as more water keeps being absorbed.
5. Medical conditions like irritable bowel syndrome which may present with either diarrhoea or constipation, abdominal pain and gas or feeling bloated.
6. Other rare causes include diseases like diabetes that may also cause constipation especially if it lasts for prolonged periods and persists despite all the lifestyle adjustments.
7. Some medicines like  those used to treat anaemia like Iron supplements  may lead to constipation.

Signs and symptoms of constipation

1. Less frequent than usual pattern bowel movements
2. Normal frequency but hard stools that may be described as pellets or big.
3. The child may complain of feeling full or bloated all the time hence have a reduced appetite
4. Pain or crying when having a bowel movement
5. Straining to make a bowel movement evidenced by noise, facial expression or for an older child taking longer than usual in the toilet.
6. Noticing a little blood stains on the tissue paper after a bowel movement.

How can I help my child deal with or prevent constipation?

1. Making sure your child drinks enough water and liquids. This can be done practically by  packing a bottle of clean  water in their school bag  that should be taken over the day or encouraging water breaks during sports or playtime over the weekends/holidays.
2. Having a balanced meal plan that has increased vegetables, fruits, beans and wholemeal grains like oatmeal, popcorn and whole-grain bread or chapatis.
3. Include mangoes and apples( with their skin), grapes, oranges and bananas in the child`s snack plan instead of junk food.
4. Reducing the amount of processed foods in the child`s diet like white wheat flour products.
5. Encourage your child to be physically active by engaging in games that make them walk or run, cycling, skipping and skating.
6. Set a regular meal schedule with adequate breaks between meals
7. Encourage and set aside adequate time for your child to make a bowel movement in the morning before they leave home if they may be uncomfortable with public/ school washrooms. Eating after a long fast(like breakfast) is a natural stimulant for a bowels movement. Try to have breakfast a little earlier and give your child a few moments to relax and pass stools afterwards. It is advisable  for each child to stick to their personal bowel movement schedule.
8. Encourage your child to make a bowel movement at whatever time of day the urge may come.
9. If you are worried that your child`s constipation is too persistent or a sign of something else visit one of our branches and seek further  medical advice from our qualified team.

What should I expect at my consultation?

• The doctor will take a detailed history of your child’s diet. It may be wise to carry a food diary/ record that you may have kept over the last three to fourteen days.
• He/ She will ask about any medications that your child may be taking. (Carry the medication with you or  write down the names/ take a photo  if they are refrigerated or cannot be carried for whatever reason)
• He/ she will ask about your child`s bowel habits, frequency, timing and nature of stools. ( try and have a record of this with the assistance of any other person who spends a lot of time with your child)
• The doctor will examine you.
• You may be sent for some investigations depending on your individual presentation. These may include stool samples laboratory examination, x-rays of the abdomen and/or blood tests. Note that stool samples should reach the laboratory within two hours of being voided. Each case is different and you may not be subjected to any of these tests.
• The doctor will thereafter give you advice on any adjustment you may need to make on your child`s diet or lifestyle.
• You may then have some medication prescribed to assist with softening your child`s stools or make bowel movements easier. If your child`s problem has been on for long, you may be encouraged to take these medication for about ten to fourteen days even though the stools may now be softer so that your child`s rectum( the stool storing part of the intestine) that may have expanded during constipation to return  to its normal size. This is done to reduce the chances of a  recurrence of the problem.
• Occasionally if there is a complete block ( faecal impaction) some medication may be given to your child through the anal opening to force out the impacted stool that may be causing severe discomfort. This should be done by a qualified medical practitioner.
• If none of these interventions relieve the problem you may be referred to a gastroenterologist, who is a doctor specialised to deal with medical conditions affecting the digestive system and related organs.