Constipation is a fairly common condition in children. In children and infants it has a significant effect on your child’s life and on the life of the whole family, and it is one of the most common reasons for visiting the family doctor.

How to recognise the symptoms:

  • fewer than one or two bowel movements a week
  • difficult or painful passing of stools
  • clenching of the buttocks
  • a bloated abdomen
  • traces of stool in the underwear that resemble diarrhoea

Diagnosis

To make a diagnosis, the symptoms alone are insufficient. Seeing a doctor is often advisable. The best clinics in Switzerland offer diagnosis and treatment of the highest standard.

Treatment

Treatment should first and foremost include hygiene and dietary measures, namely training of the anal sphincter.

For children over the age of 4, a programme of “sitting” on the toilet for 5–10 minutes should be established under the following conditions:

  • after meals (as the gastrocolic reflex is triggered after eating);
  • when there are abdominal cramps;

It is very important to treat any underlying condition where one exists, or to use symptomatic treatment to improve quality of life and prevent complications. If the problem becomes more severe, you can have an examination and treatment in Switzerland, where you will receive expert care.

Above all, a proper understanding of the physiology of defecation is needed.

Ideally – though it is not essential – a bowel movement once a day is recommended.

A regular time for bowel movements should be established, ideally 15–30 minutes after a substantial breakfast.

A glass of cold fruit juice on an empty stomach before breakfast, or a hot coffee after it, is recommended.

A laxative may be used at first; after 3–5 days the bowel will become accustomed to emptying on its own at the set time.

Remember the environmental factors – quiet and a clean toilet – which psychologically support defecation.

Causes of constipation in children

Constipation in children may have the following causes:

  • changes in diet: for example, when a child starts eating the foods adults eat;
  • drinking too much cow’s milk;
  • not drinking enough fluids (for example, in summer, when temperatures rise);
  • travelling, when they have to use an unfamiliar toilet;
  • changes in the child’s daily routine: for example, starting school;
  • an anal fissure;
  • at school, children may feel embarrassed to use the toilet;

Certain health and dietary problems

Some health and dietary problems can cause constipation in children:

  • insufficient fibre intake
  • insufficient fluid intake or dehydration
  • Hirschsprung’s disease
  • conditions affecting the brain and spine
  • spinal cord or brain injuries
  • conditions affecting metabolism, such as diabetes
  • conditions affecting hormones, such as hypothyroidism
  • problems that can block or narrow the colon or rectum, including a tumour

Preventing constipation in children

To help prevent constipation in children:

  • Offer your child foods high in fibre. A fibre-rich diet can help your child’s body form soft, bulky stools. Give your child more high-fibre foods such as fruit, vegetables, beans, cereals and wholegrain bread. If your child is not used to a high-fibre diet, start with a few grams of fibre a day to prevent wind and bloating.
  • The recommended intake of dietary fibre is 14 grams for every 1,000 calories in your child’s diet.
  • For younger children, this means around 20 grams of dietary fibre a day. For teenage girls and young women, 29 grams a day. And for teenage boys and young men, 38 grams a day.
  • Encourage your child to drink plenty of fluids. Water is best.
  • Encourage physical activity. Regular physical activity helps stimulate normal bowel function.
  • Create a toilet routine. Set aside time regularly after meals for your child to use the toilet. If necessary, provide a footstool so that your child can sit comfortably on the toilet and has enough leverage to pass a stool.
  • Remind your child to respond to the call of nature. Some children become so absorbed in play that they ignore the urge to have a bowel movement. If such delays happen often, they can contribute to constipation.
  • Support your child. Praise your child’s efforts rather than the results. Give children small rewards for trying to have a bowel movement. Stickers, a special book or a game that is available only after (or perhaps during) a visit to the toilet can serve as rewards. Respond calmly and without punishment when a child soils their underwear.