Many children suffer from constipation for various reasons, and it is often related to their eating and daily habits. Although it is not a symptom that indicates serious health problems, it may be evidence of intestinal obstruction. Therefore, it is necessary to understand the cause of this condition and treat it, especially since it may cause pain and discomfort to the child, which negatively affects his appetite and behavior. In this article, through the Dalili Medical website, we will review the common causes of constipation in children and provide tips for dealing with it.

How can you recognize infant constipation?

 

When we talk about constipation, we mean the condition in which the child has difficulty defecating, despite his attempts that may include tightening his eyes and lips, which leads to redness of his face and tension of his entire body. The child feels pain when trying to defecate, and the stool is often hard and intermittent. Older children may complain of abdominal pain, show signs of nervousness, in addition to gas or loss of appetite. Sometimes, stool may be expelled unexpectedly, which can be misunderstood as relaxation. When bowel movements become painful, the child avoids bowel movements later for fear of the pain they may face, which leads to a vicious cycle that worsens the problem of constipation.

How can I know if stool is accumulated?

 

Some signs can indicate stool accumulation, such as leaking some stool in the form of liquid, feeling abdominal discomfort, bloating, and feeling pain or soreness in the abdominal area.

What are the types of constipation in children?

 

. **Functional constipation**:   This is the most common type among children, and occurs as a result of obstructions in bowel movements or due to the child having a digestive tract infection.

. **Organic constipation**:   Also known as secondary constipation, it refers to constipation that results from certain health problems, such as digestive disorders, thyroid problems, or other disorders, in addition to the effect of some medications.

What is normal stool?

 

What exactly is normal stool? Parents may have different understandings of this concept. When visiting the doctor to vaccinate the child, parents may sometimes need to ask to see a stool chart. The shape of normal stool varies according to age group. When a baby is less than 6 months old and is breastfed, it is normal for the stool to be liquid or loose and curdled. When the baby starts eating complementary foods at 6 months old, the stool may become creamy, but it is still not solid. It is not normal for a baby under 2 years old to pass thick, paste-like stool in a tube-like shape, as happens when you squeeze a toothpaste tube. This happens when the baby resists emptying his bowels, which leads to the stool getting stuck in the colon, and this is considered a symptom of constipation.

What are the causes of constipation in children?

 

It is important to understand the causes behind constipation to avoid the problem turning into a chronic condition in the child, and to avoid complications or increased pain. Possible causes of constipation in children include the following:

1. **Genetic constipation in infants**: In this case, there is a family history of constipation in one or both parents, or even in older siblings, as a result of hereditary digestive problems.

2. **Functional constipation**: This type is related to the type of food provided to the child, as artificial milk is one of the most common causes of constipation, especially if the type of milk is not suitable for the child's sensitive stomach, which is known as milk allergy.

3. **Changing the type of milk for the infant**: Whether the child has switched from natural milk to artificial milk, or the type of milk has been changed several times, this change can be a possible cause of constipation.

4. **The infant has consumed large amounts of artificial milk**: As not all of its components are absorbed in the child's stomach as is the case with breast milk, which leads to some elements remaining that come out in the form of stool. Therefore, excessive consumption of artificial milk may make it difficult for the child to defecate normally. Constipation can be the result of a digestive tract infection, which leads to hardening of the stool with the presence of clotted blood.

Stool suppression or withholding: A child may suppress stool because he is busy playing or because he is away from home and does not want to use public toilets, or because he is already constipated and is afraid of the pain associated with defecation).

Illness: If a child is sick and has lost his appetite, a change in his diet may cause constipation. Constipation may also be a side effect of some medications such as iron supplements or may result from certain medical conditions, such as hypothyroidism.

Unbalanced diet: A child eating a large amount of foods rich in fats such as fast and fried foods, as well as soft drinks, lack of fiber intake and not drinking enough water, all of these eating habits contribute greatly to constipation. Children who drink large amounts of cow's milk daily may also suffer from constipation.

Change in the child's routine: Any changes in the child's routine may affect his general health and bowel movement such as travel, climate changes, moving to a new home, etc.

Lack of exercise: Children who watch a lot of TV and play video games do not get enough exercise. Exercise helps move digested food through the intestines.

Emotional problems: Feeling stressed about school, friends, or family can cause a child to have a change in bowel movements and become constipated.

In rare cases, constipation can be caused by physical problems, including:

- Problems with the intestines, rectum, or anus.

- Problems with the nervous system, such as cerebral palsy.

- Problems with the endocrine system, such as hypothyroidism.

What are the signs of constipation in children?

 

The signs of constipation in infants vary from person to person.The symptoms that appear in adults include:

- Delayed bowel movements, as the child may not have a bowel movement for several days in some cases.

- Difficulty in passing stool.

- Feeling pain during bowel movements, which may cause the child to cry or scream.

- The stool is hard.

- Unusual swelling in the child's abdomen, with a hard texture when touched.

- Severe constipation may lead to a small amount of liquid stool leaking into the diaper.

In severe cases, parents may notice drops of blood with the stool during diaper changes.

The child may also feel constant colic.

The anal area may appear red or suffer from inflammation.

Also, the infant may have a fever and vomiting, which affects his ability to feed properly.

**Possible complications of constipation**

Constipation is considered a simple medical condition that requires prompt treatment without posing a risk to the child's health. However, in cases of chronic constipation, some complications may appear, including:

- The appearance of painful cracks in the skin around the anus, known as (anal fissures).

- Rectal prolapse, where the rectum protrudes from the anus.

- Stool accumulation in the colon and rectum, which may lead to stool leakage, known as (encopresis).

Symptoms that require a visit to the doctor?

 

Constipation is not related to the number of times of defecation, but in some cases symptoms and signs may appear that require consulting a doctor. These symptoms include:

- The child suffers from difficulty in defecation and does not feel comfortable during that.

- The presence of very hard stool.

- Not defecating even once within a period ranging from 5 to 10 days.

- Continued abdominal pain and the child screaming without a clear reason.

- Continued constipation despite taking appropriate treatment measures.

**What is the diagnosis of chronic constipation in children?**

 

Before starting treatment for chronic constipation in children, the pediatrician's diagnosis is based on assessing the symptoms and collecting the child's medical history. The doctor's questions may include the following

- Does he feel pain during bowel movements?

- Is the child currently toilet trained?

- What kind of food does the child eat?

- Has the child been exposed to any worrying situations recently?

- Are there signs of stool in his underwear?

No additional tests are usually needed, but the doctor may examine the child by inserting a finger into the rectum to check for any possible abnormalities. In cases of severe chronic constipation, the doctor may recommend the following tests:

- **Abdominal X-ray**: This can reveal the amount of stool accumulated in the large intestine.

- **Barium enema**: The doctor gives the child an enema containing barium liquid, which helps clarify the organs during the X-ray, and then the X-ray is performed to examine the abdominal area for any problems such as blockage.

- **Anal manometry**: This test aims to measure the strength of the anal muscles and the response of the nerves, in addition to the child’s ability to feel during bowel movements.

Colonoscopy: The doctor uses a thin, flexible tube with a light and a camera at one end, which is inserted into the rectum and intestines. Colonoscopy helps doctors detect any potential problems and take tissue samples.

Laboratory tests: Doctors may recommend additional tests before starting treatment for chronic constipation in children, such as blood or urine tests, to check for underlying health conditions, such as thyroid problems or urinary tract infections.

**Treatment of infant constipation with medications**

It usually takes some time for an infant to get rid of constipation, and improvement does not necessarily occur immediately. If the child's condition does not improve, it is necessary to consult a doctor and provide all information related to the child's condition, so that the doctor can determine if there is a medical reason behind this condition and the extent to which the infant needs to use laxatives. The doctor may prescribe some medications, such as:

Glycerin suppositories, which are used to relieve severe constipation in infants and relieve pain during the bowel movement process.

It is important to be careful when using any laxatives for a child without consulting a doctor, as regular use may lead to the child becoming dependent on them, which may cause him difficulty in defecation without them in the future.

#### Treating constipation with herbs

**Cascara Sagrada**: This herb is extracted from the bark of the sacred shell plant, and it works to stimulate the colon, which increases bowel movement and helps facilitate the defecation process. However, it is recommended not to use it for long periods, but rather it is preferable to use it only at specific times.

**Psyllium**: Psyllium is used to treat chronic constipation, and is often combined with laxatives. Some people may experience side effects such as nausea, stomach pain, or vomiting after using it.

**Senna**: Senna is known for its effectiveness in emptying the colon and intestines before medical procedures, so it is best to use it for short periods and for specific purposes only. It is not recommended for long-term use, and it is also available in easy-to-use pharmaceutical forms in pharmacies.

**Rhubarb**: Rhubarb is commonly used in the kitchen, as it is added to many dishes. In addition, it plays a role in improving the health of the digestive system and facilitating the process of excretion.

What are the necessary steps to avoid constipation in children?

 

1. **Provide sufficient fluids**: It is necessary to ensure that the child gets enough fluids. Breastfed children usually get the necessary fluids, but attention must be paid to providing sufficient fluids for children who drink formula milk.

2. **Increase the consumption of foods rich in fiber**: It is necessary for the meals provided to children to be varied and contain foods rich in fiber such as fruits and vegetables, as these foods play an important role in promoting digestive health.

3. **Encourage movement and physical activity**: Children should be allowed to move a lot, instead of spending time inPlaying with electronic devices. It is important for them to participate in physical activities that help them stay active.

4. **Organize toilet times**: A schedule for using the toilet should be set, such as after meals or before bedtime, to reinforce toilet habits. The child can also be rewarded for adhering to this habit, which helps improve his digestive system.

5. **Provide a comfortable position while sitting on the toilet**: When the child sits on the toilet, his feet should be touching the floor. If the toilet is too high, a small stool or platform can be used to ensure his comfort.

6**Some children may avoid relieving themselves when circumstances change, such as moving to kindergarten or nursery or having a nanny. It is important to communicate with the child to find out if this is the case. The child should be calmly reassured so that he realizes that defecation is not a cause for concern. It should be emphasized that meeting his toilet needs is not something to be ashamed of or anxious about, but rather a normal part of life. If parents have difficulty dealing with this issue, they can consider consulting a psychologist if necessary.

#### Juices and drinks that help relieve constipation

What is the best juice to use to treat constipation in children? Is apple juice a suitable option? If your child has difficulty choosing food, you can rely on drinks and juices as a solution. Fruit and vegetable juices are effective in treating constipation, as they act as natural laxatives. Here are the most prominent juices that can help relieve constipation in children:

- Sweet lemon juice (mosambi juice)

- Pineapple juice

- Apple juice

- Lemon juice

- Watermelon juice

- Orange juice

- Cucumber juice

### The most prominent recipes for treating constipation in infants over 6 months

Natural methods and foods are among the safest and easiest options for treating constipation in infants. Here are the most prominent recipes for treating constipation in children over 6 months of age:

#### Brown sugar solution Brown sugar solution is effective in treating constipation in infants over one year of age. You can prepare this solution by mixing half a teaspoon of sugar with half a cup of water, then giving it to your child twice a day.

#### Natural Coconut Oil Natural coconut oil is used as a quick and effective treatment to facilitate the passage of stool in infants. You can add 2 to 3 milliliters of coconut oil to your baby's food if he is over six months old. If he is younger, you can apply coconut oil around the anus to facilitate the process of defecation.

#### Tomatoes Tomatoes are considered one of the beneficial foods for treating constipation in infants over 6 months old. You can boil a small tomato with a cup of water, then strain it after it cools, and give your child three to four tablespoons of this juice daily.

### Fennel seeds Fennel seeds are considered a valuable health source, as they contribute to treating digestive problems in both children and adults.

### Pear juice Pears are a fruit rich in pectin and dietary fiber, which makes them effective in treating constipation in infants. It is preferable to give them to the child in a diluted form, so it is recommended to mix an amount of pear juice with an equal amount of water, then give this mixture to your child to facilitate bowel movement.