Children's Constipation

Constipation can be a serious medical issue. Research shows that children with chronic constipation have a worse quality of life than those with more serious medical conditions such as inflammatory bowel disease and gastro-esophageal reflux disease. The statistics are staggering. Constipation affects 25–30% of young children and toddlers which also increases the risk of urinary tract infections. The Journal of Pediatric Health Care states that constipation accounts for nearly 8% of all pediatric outpatient visits, as well as more than 25% of all referrals to gastroenterology specialists. In 2015 alone, functional constipation had a worldwide prevalence of 15–45%, with approximately 40–75% of chronic constipation in children resulting in fecal impaction.

Since 2015, researchers have found that the number of constipated children seen by primary care doctors has nearly doubled. Caring for children with constipation is also expensive, with associated healthcare costs reaching an estimated $5.2 billion a year.

The majority of children and toddlers (about 95% of the reported cases) have functional constipation meaning it's not due to "secondary" causes like medications or medical conditions. This type mainly affects children between the ages of 2 and 4 when toilet training starts. (source ncbi.nlm.nih.gov)

DocuSol® Kids - Fast, predictable results typically in 2-15 minutes.

Different Types of Constipation Medication for Kids

Constipation medications are broken down into the following general categories:

  • Stool Softeners: Stool softeners for kids are oral or rectal, and work by drawing water into the bowel from surrounding body tissues, replicating a standard bowel stimulus and softening the stool. Because stool softeners increase the amount of moisture in the stool, it allows for a more comfortable bowel movement that should not require straining. Oral stool softeners can take 12 – 72 hours to be effective.
  • DocuSol® Kids (rectal) works within 2 – 15 minutes.
  • Hyperosmotic Laxatives: These laxatives increase the amount of water in the intestines to allow easier passage of stool and can be taken orally or rectally.
  • Stimulant Laxatives: These can be administered orally or rectally, and work by stimulating the rectal muscles, activating them to push stool out.
  • Lubricant Laxatives: These are taken orally or rectally, and work by coating stool in a lubricant, making it slippery and more comfortable to pass.

Ingredients Found in Stool Softeners & Laxatives

  • Stool Softeners: docusate sodium and docusate calcium
  • Lubricant Laxative: mineral oil
  • Stimulant Laxative: bisacodyl and sennosides
  • Osmotic Laxative: polyethylene glycol and glycerin

We all know how uncomfortable and painful it can be, so every parent wants to help relieve their child's constipation as quickly and safely as possible. After trying natural remedies, a parent may decide that medication or medical treatment is needed to alleviate constipation in kids.

With so many choices, how does a parent decide which constipation relief is best for their child? As with all health conditions, it's always important to consult a doctor or pediatrician to get a more informed summary of your child's particular situation. However, we can provide a useful overview of medications and natural remedies, which we hope will help you get a better sense of which are safest and most effective for your kids.

Foods to Help with Constipation in Children

To help relieve children's constipation, an adequate daily intake of fiber is essential. In addition to relieving constipation in kids, dietary fiber is also part of overall health and well-being and helps prevent future bowel irregularity. Daily fiber intake is different for each child, depending on age, gender, and other factors, so it's always a good idea to consult with a pediatrician to determine what is best for your child.

Here are some foods that are high in fiber:

  • Fruits: Most kids love fruit, and many fruits are a great source of fiber! Berries, oranges, pears, and apples (leave the skin on!) are great examples of fruits that are high in fiber.
  • Whole Grains: Some simple food replacements can help ensure your child is getting enough fiber. For instance, substitute whole wheat bread for white bread. Also consider serving high-fiber oatmeal, whole-wheat pasta, and cereals that are high in bran.
  • Legumes: kidney beans, black beans, soybeans, lentils, and chickpeas are high in fiber. Many kids don't like these foods plain, so work them into recipes your kid loves instead!
  • Vegetables: Yes, it can be challenging to get children to eat their veggies! Broccoli, green beans, peas, and carrots are fiber-rich foods that many kids love to eat!
  • Nuts: Providing your child doesn't have a nut allergy, pecans, almonds, and peanuts are healthy snacks that are high in fiber.

There are also foods to avoid to help relieve children's constipation (or to help prevent constipation), including snack foods that are high in unhealthy fats, sodium and sugar, including:

  • Chips
  • Fast foods
  • Red meat (chicken, pork and fish are better protein options)
  • Prepared or processed foods
  • Dairy products that are high in sugar
  • Traditional “binder” foods such as rice and bananas

What is children's constipation?

Bowel patterns vary from child to child, just as they do in adults. What's normal for your child may be different from what's normal for another child. Most children have bowel movements one to two times per day. Other children may go two to three days or longer before passing a normal stool. For instance, if your child is healthy and has normal stools without discomfort or pain, ­having a bowel movement every three days may be your child’s normal bowel pattern.

Children with constipation may have stools that are hard, dry, and difficult or painful to pass. These stools may occur daily or be less frequent. Although constipation can cause discomfort and pain, it's usually temporary and can be treated.

Constipation is a common problem in children. It's one of the main reasons children are referred to a specialist, called a pediatric gastroenterologist.

What are the signs of constipation in children?

  • Many days without a normal bowel movement
  • Children who produce stools that look like pebbly rabbit droppings.
  • Toddlers who routinely strain to pass hard stools.
  • Abdominal pain, such as stomachaches, cramping, or nausea.
  • Rectal bleeding from tears, called fissures.
  • Soiling.
  • Poor appetite.
  • Cranky behavior.
  • A protruding abdomen and a decrease in appetite.
  • Having (Experiencing) pain during a bowel movement.

What causes constipation in children?

Constipation frequently occurs for a variety of reasons.

  • Diet. Changes in diet, or not enough fiber or fluid in your child's diet, can cause constipation.
  • Illness. If your child is sick and experiences appetite loss, a change in diet can throw their system off and lead to constipation.
  • Medicine. Constipation may be a side effect of some medicines.
  • Medical Conditions. Constipation may result from certain medical conditions, such as hypothyroidism (underactive thyroid gland).
  • Withholding. Your child may withhold stool for several different reasons. Children often withhold to avoid pain from passing a hard stool. Children who might be dealing with independence and control issues may also withhold—this is commonly seen between the ages of two and five years old. It is not uncommon to see children withhold while at school, at a friends house or camp because of embarrassment or being uncomfortable using a public toilet. Your child may also withhold simply to continue playing.
  • Other changes. In general, any changes in your child's routine, such as traveling, hot weather, or stressful situations, may affect overall health and how bowel functions.

If constipation goes untreated, it may worsen. The longer the stool stays inside the lower intestinal tract, the larger, firmer and drier it becomes. It then becomes more difficult and painful to pass.
Your child may hold back stool because of the pain. This creates a vicious cycle.

Is medicine needed to treat children's constipation?

In some cases, your child's doctor may prescribe medicine to soften or remove the stool. Consult your child’s physician about options such as DocuSol® Kids to provide relief. After the stool is removed, your child's doctor may suggest ways you can help your child develop good bowel habits to prevent stools from backing up again.

How long should I wait to contact a healthcare provider if my kid is constipated?

If your child's constipation lasts longer than two weeks, it is recommended to seek advice from a pediatrician about the right course of action.

How can children's constipation be prevented?

Because each child's bowel patterns are different, become familiar with your child's normal bowel patterns. Make note of the usual size and consistency of her stools. This will help you and your child's doctor determine when constipation occurs and how best to treat it (best treatment options). If your child doesn't have normal bowel movements every few days or is uncomfortable when stools are passed, she may need help in developing proper bowel habits.

You can…

  • Encourage your child to drink plenty of water and eat higher-fiber foods.
  • Help your child set up a regular toileting routine.
  • Encourage your child to be physically active. Exercise, along with a balanced diet, provides the foundation for a healthy, active life.

What is encopresis?

If your child withholds stool, the large stool buildup can cause rectal stretching when having a bowel movement. Your child may no longer feel the urge to pass a stool until it is too big to be passed without the help of an enema, laxative or other treatment. It is not uncommon for liquid resembling diarrhea to leak out onto your child’s underwear. This happens as liquid can only pass around the stool. This is often confusion to both parents and pediatrician, as the liquid is not diarrhea. This problem is called encopresis.

Why does an established bowel care program matter?

  • Chronic constipation is a common problem in children with disabilities and should be addressed effectively at an early stage in their multidisciplinary management.
  • Cerebral Palsy: Fecal incontinence, or encopresis, and constipation are common bowel and bladder problems among adults or children with cerebral palsy.
  • Spina Bifida: Due to nerve damage between the spinal cord and the bowel system, bowel incontinence and constipation are associated with spina bifida.
  • Constipation is often associated with bouts of diarrhea because the soft and runny stools that are stuck above the “hard stools” that cause constipation cannot be processed by the bowel properly and will flow around the hard material causing a bout of diarrhea.
  • Chronic constipation also stretches the bowel and leads to weakened sensation. This stretching can take years to get back to normal.

How Does DocuSol® Kids work?

The DocuSol® Kids formulation functions as a stool-softening, hyperosmotic laxative by drawing water into the bowel from surrounding body tissues. The docusate sodium acts as a softener by preparing the stool to readily mix with watery fluids. The increased mass of stool promotes a bowel evacuation by stimulating nerve endings in the bowel lining and initiating peristalsis. Not only does it soften and loosen the stool, but it initiates a normal stimulus. DocuSol® Kids provides a natural, replicated bowel movement.

What to Do If My Child or Toddler is Constipated

Before making any decisions about giving your child over-the-counter constipation medication, it's essential to talk to a pediatrician to determine what treatment is best for your toddler or child. Try at-home remedies first, as discussed in this article, and keep track of what works and what doesn't in a daily food and beverage diary. This way, if you do need to consult with a pediatrician, you are more informed about your child's bowel movements and patterns.

Try to stick to a bowel routine as much as possible to encourage bowel regularity and get your child accustomed to a regular bowel routine. First thing in the morning and about 30 mins after a meal are good times to encourage your child to use the bathroom.

DocuSol® Kids Can Help!

Changes in Diet

DocuSol® Kids is a first-of-its-kind, mini enema with a non-irritating formula that functions as a stool-softening, hyperosmotic laxative by drawing water into the bowel from surrounding body tissues, replicating a normal bowel movement. This unique formulation provides children ages 2–12 fast, predictable relief of constipation within 2 – 15 minutes.

DocuSol® Kids was designed for easy use at home. The DocuSol® Kids tube is designed to offer a minimally invasive, soft, and flexible tip, avoiding any scratching or irritation to the skin. Just a 5-milliliter tube delivering 100mg of docusate sodium, the medication provides fast relief in just a few, easy steps!

Learn more about DocuSol® Kids on our website, including:

Learn more about DocuSol® Kids on our website, including:

Disclaimer: The materials contained on this website are for reference purposes only. Always consult your physician for healthcare questions. Quest Products, LLC and Summit Pharmaceuticals do not assume responsibility for patient care or the accuracy of the processes. presented. All rights reserved. Copyright 2019.
Sources:
https://www.sciencedirect.com/science/article/pii/S0022347614008798

https://journals.lww.com/jpgn/Fulltext/2005/07000/Chronic_Childhood_Constipation_Is_Associated_with.12.aspx

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356179/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574579/