$Unique_ID{PAR00043}
$Pretitle{}
$Title{Medical Advice:  Constipation}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Constipation large Hard dry stool Painful bowel movements blood
bloody stools Abdominal cramps appetite Loss Enema Enemas suppository
suppositories laxative laxatives constipated}
$Log{}

Your Child:  A Medical Guide


Constipation


     Quick Reference

     SYMPTOMS
     - Hard, dry stools
     - Stools larger in diameter than usual
     - Pain during bowel movements
     - Red blood on or around stools
     - Abdominal cramps
     - Loss of appetite

     HOME CARE
     For immediate, temporary relief:
     - Use a glycerine suppository or give an enema.

     For long-term cure:
     - Include more roughage in your child's diet (fruits, vegetables, and
       unrefined grains).
     - Give your child fewer constipating foods, such as milk and milk
       products.  (Check with your physician to ensure that your child's diet
       is nutritionally adequate, however.)

     PRECAUTIONS
     - Do not give laxatives to a child unless recommended by your doctor.
     - Do not use enemas, suppositories, or laxatives on a regular basis.
       They are habit-forming.
     - Do not assume that a child is constipated if bowel movements do not
       occur daily.  Constipation is hardness of the stools; it has nothing to
       do with the number of bowel movements.  Normal, healthy children may
       have several bowel movements a day or only several a week.
     - If a child becomes constipated during toilet training, stop training
       efforts.


     Constipation is a condition in which the stools (bowel movements) are too
hard.  The function of the colon (large intestine) is to store unabsorbed food
waste and to absorb and hold water from the liquid material received from the
small intestine.  If the colon absorbs too much water, the stools become hard.
     The frequency of bowel movements is not a factor in constipation.
Passage of six too-firm stools a day is considered constipation.  Passage of
one normal or soft stool every third or fourth day is not constipation.  Many
normal, healthy children have a bowel movement only every few days and are not
constipated.  The hardness of a stool is judged by appearance and by diameter.
A stool greater than twice the usual diameter is probably too hard.
     In more than 95 percent of cases, constipation is not caused by any
physical abnormality.  In such cases, constipation can usually be cured by
changes in the diet or by using medications that soften the stools.
     In children, there are two common causes of constipation.  The first is
that the diet does not include enough roughage, which holds water in the
stools.  Foods that prevent constipation are all fruit juices and all fruits
(particularly those eaten with the skin on) except bananas; all vegetables,
especially if eaten raw, except peeled potatoes; and unrefined grains
(whole-grain cereals and breads).
     The second common cause of constipation in children is that the child is
resisting the normal impulse to move the bowels.  (This often occurs when
parents put too much pressure on the child during toilet training.)  As a
result, the colon continues to absorb water from the retained stools, which
then become too hard.  As the stools become harder, bowel movements become
painful.  Fear of such pain makes the child even more determined to postpone
bowel movements.  Constipation enlarges the colon, causing a loss of muscle
tone, and the physical impulse to empty the bowel becomes weaker.  This cycle
can lead to chronic constipation.

SIGNS AND SYMPTOMS

     The major sign of constipation is stools that are too hard, too dry, and
larger in diameter than usual.  Constipation can cause pain in the anus during
bowel movements.  Red blood may appear on and around the stools.  Other
symptoms are cramps in the abdomen and an eventual loss of appetite.
     If constipation continues for days or weeks, paradoxical diarrhea may
develop.  In this condition, loose, watery stools seep around the hard stool
in the colon and are passed as diarrhea.  When this happens, it can be
difficult to tell whether the child has constipation or diarrhea.

HOME CARE

     For immediate temporary relief, use a glycerine suppository or disposable
commercial enema.  For a long-term cure, increase the amount of roughage and
decrease the amount of constipating food in your child's diet.  (Check with
your physician to ensure that your child's diet is nutritionally adequate.)
If constipation occurs during toilet training, stop training efforts.

PRECAUTIONS

  -  Check with your doctor before giving laxatives to a child.  Laxatives may
     force passage of a hard stool and cause pain that leads to further
     holding back by the child.
  -  Enemas, suppositories, and laxatives are habit-forming.  They should
     never be used on a regular basis.
  -  Do not assume that a child is constipated simply because bowel movements
     do not occur every day.

MEDICAL TREATMENT

     Your doctor will perform a rectal examination and a careful examination
of the child's abdomen.  X-ray studies of the bowel may be performed to look
for possible physical abnormalities.

RELATED TOPICS:  Diarrhea in older children; Diarrhea in young children;
Stomachache, acute; Stomachache, chronic