Constipation is very common in potty-trained children. Frequently this starts as one large semi--hard bowel movement, which may be due to a decrease in fluid intake or not enough fiber in the diet. This stool will produce some pain and can cause a tear or raw area. Even if the subsequent stools are soft the next bowel movement will cause pain over the raw area or tear. The child quickly learns that bowel movements hurt. Children try to avoid pain so they stop the bowel movement and begin to hold bowel movements instead of passing them. This is called stool hoarding .
Over time stool hoarding causes the rectum to stretch and become desensitized to filling. Eventually the stool becomes very large and hard. Anytime they try to pass stool it hurts. Often these children will have abdominal pain and even stool accidents.
The treatment is to empty the rectum of stool and keep it empty as the rectum shrinks in size. This can take six to twelve months . The stages of treatment include:
- Clean-out Phase,
- Maintenance Phase for six to twelve months, and then
- Weaning Phase. You need to ask your doctor which medicines (Pediatric Fleet's enema's, Milk of Magnesia, etc) are best for your child.
Links for help with constipation:
A diet low in fiber and high in fat including fatty foods, fried foods, processed food (like cheese crackers), and dairy products can add to the problem of constipation. Dairy products should be eaten in moderation. See the Food Pyramid for more information on a good balance of foods.
More tips on getting your child to eat more:
Please talk to your doctor if your child has fever, vomiting, abdominal pain, lack of appetite, poor weight gain or loss, or appears ill.