Constipation or passing of hard stools, that too, infrequently is a common problem in children. Although the definition of constipation varies in various countries, passing of at least once a day is satisfactory in our culture. In a newborn, normally the baby should pass almost immediately after birth within the first 12 hours. Many soft stools in a day while on milk feeds are normal.
Causes of constipation in Children:
Hypothyroidism or less function of thyroid gland. Nowadays, the babies are tested almost routinely after birth.
Anatomical causes in the anal region like anal stenosis (narrow anal opening), anorectal malformations (congenital birth defects) etc.
Intestinal obstruction (obstruction to the flow of contents in the intestinal tract) causes like Hirschsprung’s disease (congenital megacolon, aganglionosis) or acquired conditions like anal fissure etc.
Inadequate feeds for any reason like Pyloric stenosis (stomach obstruction resulting in vomiting) or for that matter chronic vomiting for any reason.
In bigger children, habitual constipation due to only milk feeds without solids in diet, not drinking enough water or accustomed to junk foods, no fiber in diet etc.
Treatment for Constipation in Children:
*In the newborn period, gentle stimulation of the rectum with a soft catheter may help. Rule out local abnormalities by diligent medical examination.
*In bigger children, the addition of solids in diet, ruling out anal fissures, plenty of fruits & vegetables in the diet, generous fiber containing food and plenty of water to drink are the measures that would help. It should be observed if the children are too lazy to go to the toilet while busy watching movies, games or mobile usage. They should be encouraged to lead a healthy lifestyle in terms of adequate physical exercise.
*If Hirschsprung’s disease is suspected, investigations with plain X-rays, barium enema examination or even rectal biopsy may be needed for diagnosis and appropriate management. Even this disease, if adequately treated by experts, should result in good results.
Medicinesfor Constipation in Children:
Stools lubricants like liquid paraffin, stool softeners like Lactulose and purgative medicines may be needed for lazy rectums. In persistent cases, periodic enemata or even total bowel irrigation may be resorted to, for achieving the desired result.