Constipation
Constipation is the difficult and infrequent passing of hard, dry stools.
Parents often worry about how often their children have bowel movements. However, constipation generally does not have any serious consequences and should be a concern only when passing stools becomes painful and leads to withholding of stools, or when constipation causes other symptoms.
Causes and Symptoms
Constipation is extremely common in children. The most common cause is insufficient amounts of fruits, vegetables, and whole grains (fiber) in the child's diet.
Children who are constipated often report intermittent abdominal discomfort. After a time, parents may notice soiling of the child's underwear because liquid stool from the intestine involuntarily leaks around hard stool in the rectum. Small amounts of blood may appear from small erosions (fissures) caused by the passage of hard stools. Occasionally, constipation can lead to difficulty with urination.
Treatment
Minor cases of constipation can be treated by increasing the child's dietary fiber, either with whole grains and fruits or with a supplement such as psyllium. Good hydration is important. Sometimes, reducing the intake of milk helps constipation. Children become distracted and typically do not sit long enough on the toilet to pass constipated stools. They need to be guided to sit an adequate time on the toilet at regular intervals--at least twice a day--so they can establish a routine that gives them the opportunity to defecate fully. Parents can use enemas and stool softeners, such as mineral oil or milk of magnesia, to facilitate this process if necessary.
Children accustomed to withholding their stools may need several months of stool softeners to get them reconditioned to soft, comfortable stools.
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