Bowel Problems in Childhood

Bowel problems are not limited to adults and are definitely not just part of getting older – children can experience them too. Some children will be born with bowel conditions while others can develop them as they start to grow. In this section you will find some basic information on children’s constipation and support for parents, guardians and carers.

Causes of Constipation in Children

When a child is being potty trained they are learning how to recognise the need to go to the toilet.  If they become too engrossed in an activity the need to go can be ignored. This problem can become a more regular occurrence in some children which can lead to constipation. Childhood constipation is very common in younger children, around 1/3 of under 9s suffer from it at some point often with no known reason. Constipation is classified in children as less than 3 poos a week.

There are a number of other reasons why a child can have constipation. These include:

• Avoiding going to the toilet
• Fear of going to the toilet
• No firm toilet routine
• Too little fibre in diet
• Low fluid intake
• Emotional upset
• Taking medication

Symptoms of Constipation in Children

If your child is still in nappies then you may be able to gauge whether they are constipated from the number of soiled nappies you change. Some babies fill their nappies at or around every feed. Some, especially breastfed babies, can go for several days or even up to a week without a bowel movement. Each baby is different but you will know what is right for your child.

If your child usually has regularly bowel movements but you have not changed a dirty nappy for some time or noticed them going to the toilet, look out for some of these other symptoms which could be a sign of constipation.

• Pooing less than three times a week
• Foul smelling wind
• Painful tummy
• Poo looks like hard pellets
• Pain when pooing
• Straining
• Withholding poo
• Poor appetite
• Lack of energy
• Unhappy, angry or irritable mood
• Soiling

If you child is experiencing any of these problems, contact your GP who will be able to give you advice or assess the situation.

How to Treat Constipation in Children

You may wish to try the following remedies initially to try and ease the problem for your child;

• Introduce more fibre
• Hot drinks
• Eat more fruit and veg
• Increase their fluid intake – but not drinks high in sugar
• Try cutting out sugary foods, sweets and drinks

You must also consider;

• If they take regular medication check the side effects to see if this is causing the constipation.
• If the constipation comes and goes, it may be an idea to keep a bowel diary of what your child eats to establish if the problem is brought on by something they have eaten.

If these self-help methods do not work and the problem persists, contact your GP. They will be able to advise you of any over the counter medications suitable for children’s constipation.

If your child is not yet on solid food and is showing signs of constipation, contact your GP for advice.

Possible Tests

There are certain tests that may be carried out to assess why your child is experiencing bowel problems although these are not always necessary. These include:

• Abdominal x ray – the x ray machine is positioned over the tummy. In some cases, a child is given a special substance to swallow a few hours before the test. This allows the doctor to see the outline of the intestines and bowel.
• Transit studies – this involves your child swallowing some liquid containing small beads that will show up on an x ray. Once the beads have been swallowed, x rays will be taken over a period of a few days; The doctor will then count the beads as they appear on the x ray. This helps the doctor to assess how long it takes the stools to pass through the bowel.

There are further tests which are occasionally conducted to identify bowel problems in children who experience persistent constipation. These include:

• Barium enema x ray
• Rectal biopsy
• Anorectal balloon manometry
• Endoscopy

How to Help Your Child Keep Regular

The following tips may help a child to become more regular at opening their bowels and maintain a healthy bowel.

• Eat regular meals with lots of fruit and vegetables
• Drink up to 6 – 8 glasses of water based fluid a day
• Exercise regularly
• Regular toilet routine

Further Information

For more detailed information and support about childhood continence issues contact ERIC – Education and Resources for Improving Childhood Continence. ERIC is the national charity that provides information and support for children and young people under 18 years of age with continence issues and their families.

ERIC helpline – 0845 370 8008 – Monday – Thursday 10am – 2pm

Website – www.eric.org.uk  and  Email: [email protected]