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3 Steps to Treat Constipation in Children

Most kids will experience constipation at one point or another, but occasionally. it can become a chronic--and very frustrating--medical issue for parents to deal with. Here are 3 steps to help your child overcome constipation.

By
Sanaz Majd, MD
Episode #164
potty training

Much more commonly, kids become constipated due to lack of fiber intake, and certain behavioral patterns. They may be consuming too many foods with high simple sugars, and not enough foods with high fiber--aka junk food, fast food, processed foods, etc. Most kids I interview don’t receive the 5 servings of fruits and veggies a day that are necessary for proper fiber intake.

Another reason could be that as stooling often becomes painful, kids might withhold the stool as a response. Or, alternatively, kids may withhold stool simply because they don’t want to stop playing, so they instead delay the trip to the toilet.

As kids withhold stool, even more water is reabsorbed from the stool into the colon, and this causes the stagnant stool to become even harder and more painful to pass. Often, little bits of stool can pass through, and cause what doctors refer to as “fecal incontinence” (or soiling.)

How to Treat Constipation in Children

Unfortunately, as with everything else, when something becomes chronic and requires a change in behavior, it becomes time-consuming to treat.

Treating chronic constipation in kids may not be "easy," and there's no "magic pill."  It will require some time, patience, and effort on your part to get your child to overcome constipation and get passed it--but the good news is, it is very achievable.  

There are 3 main components in “retraining” your child’s bowel: evacuation of the plugged up poop, softening all future poops, and changing their behavior patterns:

Step 1:  Unplugging the Colon

First, you need to treat the more immediate issue: you’ve got to get them to poop out what’s plugging up the pipes right now. Here’s how doctors often do this:x

  • Polyethylene glycol (otherwise often known as “Miralax”): this is a powder you can mix into liquids your child consumes, and is often well-tolerated (meaning tasteless and odor-less.) It’s taken daily, or even twice daily, until the colon is evacuated.
  • Mineral Oil: given at 15 to 30mL per year of age per day (not quite as tasteless, so kids don't like it.)
  • Enemas: this may be the most invasive and discomforting for the child, and perhaps used as last resort for most. There are various preparations on the market, so ask your doctor what’s best for your child before you go this route.

Miralax is the most popular choice for its stated reasons. If the constipation is severe and chronic, you may want to discuss the frequency of use of these pipe-cleaners with your doctor. Sometimes, it is used more chronically (for weeks to months even,) in order to achieve soft bowel movements while simultaneously working on behavioral modification. Often, we recommend titrating the Miralax up or down in order to achieve a once a day soft bowel movement.

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About the Author

Sanaz Majd, MD
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