Constipation

What is constipation?

Constipation is the inability to have a stool. The stool frequency is individually different: some can have a stool each day, while for others it can be each third day. Infants who are fed their mother’s milk can have no stool for up to six days. In infants receiving cow’s milk, this time period can last three to four days. The consistency of the stool holds importance, as well as the easy and uncomplicated excretion of the stool. The higher the fibre content of the food, the higher the stool frequency.

With constipation, the excretion of stool is associated with pain and some children are not even able to have a stool. The bowel is re-absorbing water from the stool. With little water intake and a low fibre diet, the stool becomes harder during the passage in the bowel. The passage of the stool lasts longer and the stool becomes even harder, whereby everything leads to a negative cycle. Pain with defection causes the stool to remain longer in the bowel and become harder.

What are the complications?

If too much stool is backed up in the bowel, abdominal pain, nausea and vomiting are possible symptoms, while appetite can also decrease. A paradox diarrhoea can develop if the constipation has been present for a long time. The diarrhoea happens because fluid in the bowel passes the hard stool without being reabsorbed. If the constipation lasts for too long, a complete obstruction of the bowels (ileus) can occur. This would be a surgical emergency and life-threatening.

What is the therapy?

If the constipation is present for a long time, the first steep of the therapy is to get the stool out of the lower part of the bowel. A medical lubricant is used rectally. If this method is unsuccessful, the lubricant needs to be introduced higher in the bowel. Sometimes this must be done more than once. An admission to the hospital would be necessary for this kind of treatment.

The second step of the treatment is oral therapy. Oral laxatives need to be given to soften new stool building up in the bowel. This Therapy needs to bed done for a few weeks.

The third step of therapy is to change the behaviour of the child in case he/she has been trying to hold back stool. Additionally, the parents have to change the diet of the child. The water intake needs to be sufficient and the food needs to be high in fibre, vegetable and fruits. White bread would not be recommended at all and consumption of chocolate and sweets need to be significantly reduced.