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Chronic constipation in children

Chronic constipation can be a traumatic experience for a child. In my last article, ”how to help a child with constipation” I talked about some general ways to address constipation in your child.  But what if you have done all those things and nothing is helping.  You need to dig deeper into the root cause

I have explained the strong correlation between cows milk intolerance and constipation. That is one common, overlooked reason for constipation.

There are other, less common reasons why you might not be getting anywhere with your child’s constipation.

Other reasons for chronic constipation in children

Lead toxicity

This is an issue I see all too often in clinic.  Lead may have got into your child’s system through renovations, old ceramic crockery or even lipstick!  I do hair tissue mineral analysis with kids to see if lead could be an issue.  If lead is the issue, all the fibre in the world isn’t going to fix the constipation problem.

Coeliac disease

This is an autoimmune reaction to gluten, which can cause a wide array of symptoms, including chronic constipation. It is definitely worth invegiating if there is a family history of auto-immune disease (Hashimotos, Rheumatoid Arthritis, Type 1 Diabetes etc)

Hypothyroidism

A slowing of the thyroid gland will slow down the motility of the gut, causing chronic constipation. Although this is more common in adults, it can be a problem for some kids too.

Iron supplementation

Some kids need iron supplementation as they are anemic.  If this is the case, you need to work with a holistic practitioner to work out why (hint: if they are a fussy eater and don’t eat meat, that would be why. Talk to me about my fussy eating program!)

Some kids are just told to take iron by a well-meaning person, as a bit of an insurance policy.  Either way, many iron supplements can cause severe constipation.  You need to work out why your child needs iron and address that. In the meantime, choose a more tummy-friendly iron supplement.

What happens when severe constipation in children is left untreated?

Fissures can occur when poos are too big and difficult to pass.  These are little tears around you child’s anus.  Each time your child tries to pass a bowel motion the fissures will lead to pain, which can lead to withholding.

It is definitely recommended to seek professional help before this happens, or as soon as it happens.

Natural laxatives for children with chronic constipation

Magnesium

This is a great bowel mover for kids.  They can take it orally, as a supplement or in the bath. Either Epsom salts or magnesium salts in the bath will do the trick.

Probiotics

These can be helpful, but not all strains.  You need to work with a professional to decide what strains will work best for your child

Cod liver oil

Cod Liver Oil is one of my all-round favourite supplements for kids.  It has so many benefits, one of them being acting as a lubricant to pass a stool

Vitamin C

If you take too much vitamin C, it will give you diarrhea.  You can use that to your advantage if your child tends to get constipated and give them a big enough dose of vitamin C to move their bowels.  What that dose is depends on many factors specific to your child, so you need to do a bit of test and learn to work it out.

What do I not recommend for chronic constipation in children?

I do not recommend the heavily promoted osmotic laxatives which you can buy over the counter.

These contain an ingredient called PEG 3350.

This is often recommended for use for years on end, as it apparently is totally safe. I disagree.

Funnily enough, the same ingredient (PEG 3350) is used to clear out the entire microbiome (gut bacteria) of mice who are to be used for scientific experiments.  Given that mice studies are used to assess attributes of human health, it would be fair to assume that anything that wipes out the gut bacteria in a mouse, would do the same in a human.  Once you wipe out bacteria, they are gone forever.  No amount of probiotics will bring them back.

In the US, the product information for the most commonnly used osmotic laxative states that this should be taken for up to 2 weeks.  Not the 10 years it is often taken for.  The FDA recommends it for 7 days, to clear impaction.

Also, in the US between 2007 and 2017, 1564 adverse symptoms (AS) were reported on 645 children between the ages of 0‐21 taking this product. Of these, 919 (58.75%) were neurological, 770 of these were neuropsychiatric (83.8%), such as anxiety, anger, abnormal behaviour, etc.  Certainly, this is something to be aware of!

Getting to the root cause of your child’s chronic constipation

As a Naturopath, I help you get to the root cause of your child’s constipation.  This might mean doing some advanced stool testing that your doctor will not have done unless you see an integrative doctor.  Pinpointing why your child is constipated gives you the chance to resolve the issue – permanently. Make an appointment for a FREE 20 minute chat with me to assess if I can help your child.

https://medlineplus.gov/druginfo/meds/a603032.html

https://pubmed.ncbi.nlm.nih.gov/29906449/

https://onlinelibrary.wiley.com/doi/full/10.1002/ygh2.336

How to help a child with constipation

If your child has had constipation at some point, you are certainly not alone. 

Constipation will affect up to a third of children at some point in time. But that doesn’t make it normal. Just common. It is a sign that something isn’t right with your child, and something you should get to the bottom of (excuse the pun!).

How often should a child poop

Babies will do between 5 and 40 poos per week (remember the good old days of changing poopy nappies in the middle of the night!).

As kids get older, the bowel motions get fewer.  The actual definition of constipation in kids is less than two poos per week.  As an adult, can you imagine if you only passed a bowel motion twice a week? 

How would you feel?  Pretty grumpy, sluggish and probably in pain.

As a Naturopath, we aim for at least one bowel motion per day for optimal health.

Signs of constipation in kids

Not being able to do a poo at least every second day is a sign of some sort of issue. 

For a child with constipation it isn’t just about the frequency.  It also about the size and form of the stool.  

Extremely large poos that threaten to block the toilet indicate constipation.

Poo accidents in a toilet trained child can be overflow.  This is just the liquid which can escape around the sides of a large stool mass which is stuck in the bowel.   This is called impaction. Other signs of impaction are tummy pain, bloated belly, behavioural issues and lack of appetite or fussy eating.

Once a child has experienced the pain of passing a really large stool, they may develop some withholding behaviours.  This is where they try to avoid doing a poo, in case it hurts again

Signs that your child might be withholding (keeping their poo captive)

  • Going stiff
  • Clenching buttocks
  • Tip toe walking leaning against furniture
  • Curling up in a ball.

Quick relief for a child with constipation

If your child has constipation, the quickest relief can actually come from making one small (free) change. 

Stop dairy. 

That means no cheese, yoghurt, milk. 

In a study of 70 children with constipation, 80% had their constipation resolve completely by removing dairy. 

No medication. No supplements.  No tests.

These children did not have IgE allergies to dairy (the type you do skin prick testing with an allergist)

Flower remedies

These energetic medicines are wonderful for kids because they have no flavour. You just put some drops in their water bottle. Because there is such a big connection between emotional issues and withholding in children, flower remedies can give immediate relief.

Lactulose

This is available very cheaply in the chemist. Whilst it is sold as a laxative, it is actually a prebiotic, so its really good to rebalance your child’s gut flora.  Start with a small dose and increase gradually. It also tastes great.

Constipation in children home remedies

  • Setting toilet time (just a couple of minutes) at the same time every day (after breakfast is good) to help retrain the bowel.
  • A foot stool at the toilet to help get them into the correct position.
  • More fibre from nuts, seeds, fruits and vegetables.
  • Kiwi fruit and blackberries are particular good for keeping bowels regular.
  • More water, drank between meals, not with meals
  • Exercise – walking, skipping, running are all good to stimulate bowel movements
  • Vagus nerve stimulation – there are some fun things you can do with kids to stimulate their vagus nerve and improve their digestions.  Singing or humming before meals are two ways
  • Probiotic foods – sauerkraut, kvass.  Avoid dairy probiotic foods like yoghurt and kefir until you determine if dairy is an issue.

If you struggle to get nuts, seed and veggies in to your child, here are a few child friendly suggestsions

Four ingredient chia pudding

Chocolate milkshake

Nutella bread

Need more help for your child with constipation?

Don’t try to go it alone.  Let me support you on this journey to restore your child’s health. Have a chat with me and see if I am the right person to do this.

The Other Causes of Constipation

If you’ve ever been constipated, you’ll know how uncomfortable (and embarrassing) it can be. 

Like most people, you’ve probably googled how to treat your symptoms. But the most important part of treating constipation is understanding the cause.  

Most often, being unable to “do number twos” is related to your diet and lifestyle. First, let’s look at some of the most common causes of constipation. 

Lack of fibre

Fibre plays a big part in bowel regularity. Also known as ‘roughage’, fibre is a type of plant matter that can’t be broken down by your body. 

There are two types of fibre: soluble and insoluble. Soluble fibre acts like a sponge, absorbing fluid and making your stools softer. This allows your body to move waste out of your digestive tract more easily. Insoluble fibre adds bulk to your stool, which stimulates peristalsis (the wave-like movements of your intestines). 

Lack of fluids

Dehydration is a major factor in constipation. Your large intestine requires a lot of water to move waste along, and if you aren’t drinking enough, it will soak that water up from food waste instead. The less water in your gut, the drier your stools will be – and the harder to move. 

Lack of exercise

Insufficient physical activity and a sedentary lifestyle can slow down bowel movements. Exercise promotes the flow of blood to the intestines, which stimulates smooth muscle contraction. This is why sitting down all day in an office or long periods of travel can also affect your regularity.

So, what if you’re eating a healthy diet with plenty of fibre, drinking enough water, and exercising daily – but still getting constipated?

It could be that you’re suffering from one of the lesser-known causes of constipation: the ones that are more difficult to diagnose. 

The Other Causes of Constipation 

Hypothyroidism 

An underactive thyroid (hypothyroidism) means that your body isn’t producing enough thyroid hormone. This can slow down many of your body’s systems, including digestive function and elimination pathways. If your colon function is too slow or weak, it won’t be able to eliminate stools properly. 

Lead toxicity

Ingesting, inhaling, or touching lead can lead to lead toxicity, an environmental cause of constipation. This is more common in children who may be exposed to lead through paints or by ingesting contaminated food or water. Fortunately, the use of lead-free gasoline has dramatically reduced lead poisoning in recent years, but other environmental sources include fishing weights, vinyl miniblinds, curtain weights, and electric cables. 

As well as constipation, symptoms of lead toxicity include severe abdominal pain, vomiting, and diarrhoea.

Small intestine bacterial overgrowth (SIBO)

SIBO occurs when certain types of ‘bad’ bacteria grow out of control in the small intestine. They ferment and produce hydrogen, causing bloating and gas. This gas, in turn, can slow down stool transit time, leading to constipation. Research has also shown that the higher the methane gas elevation, the more severe constipation becomes.

Worse still, chronic constipation allows more bacteria to grow in the small intestine, which then causes more methane and more constipation. 

Gluten or dairy intolerance

Gluten and dairy products are key contributors to bowel issues. Coeliac disease and gluten intolerance are often associated with diarrhoea, but both can also cause constipation. One study showed that 13% of people with coeliac disease had constipation while 15% had both constipation and diarrhoea. Another 27% had ‘standard’ diarrhoea.

Wheat allergy, celiac disease, and gluten sensitivity are three separate conditions that can all be triggered by eating gliadin, the protein in wheat. Gluten causes an inflammatory reaction in the small intestine which can damage the gut lining, impairing your body’s ability to absorb nutrients. Along with constipation, these conditions can also cause abdominal pain, bloating, nausea, and diarrhoea. 

Dairy intolerance is usually caused by an inability to digest lactose, the sugar in milk. When lactose is fermented by bacteria in your intestines, it can produce methane gas. This methane gas slows down the time it takes food to travel through the gut, leading to constipation.

Other foods that are implicated in constipation include processed grains, red meat, fried foods, and fruits such as persimmons or plums.

How to Treat Constipation Naturally

Most short-term incidents of constipation can be traced back to a certain food or a change to your routine, such as travel. However, chronic constipation suggests that something else may be to blame. 

Because chronic constipation can have so many different causes, there is no ‘one size fits all’ approach to treatment. That’s why a comprehensive consultation with a naturopath like me is so important. I’ll investigate your entire health history, along with your current diet and lifestyle. Where necessary, I’ll recommend that you undergo testing to rule out possible health conditions that may be contributing to your constipation. 

Once we’ve identified a cause (and there could be more than one!), I’ll put together a holistic treatment plan to manage your symptoms and get you ‘regular’ again! Book in for a 20 minute chat today!

Constipation secret weapon : Seedy Muffins

Occasionally kids get constipation.  For adults, it is easy to say, ‘just take some psyllium’.  Not quite so easy with children.  I can’t imagine many children gulping down this slimy beverage.  The commercial products containing psyllium are full of artificial sweeteners and additives, I wouldn’t recommend them.  So recently when one of my children had a bit of an issue, I made some muffins containing psyllium, and lots of other ground up seeds.  Prunes and pears, famous for their laxative properties, are used to sweeten.  Hey presto, no constipation anymore!  These taste a bit sweet because of the pears and prunes, so not hard to persuade kids to eat them.  If you want to reduce the sugar content, replace the pear juice with water.  As my daughter said, ‘they taste a lot better than they look’.  They are quite small, so you can give frequent small doses of the seeds.

It is important to add, if you child suffers from ongoing constipation, or uses laxatives, you need to get them seen by a Nutritionist https://holistichealthbylisamoane.com.au/talk-to-lisa/to work out why.  Constipation isn’t normal, and using laxatives isn’t normal.

Seedy Muffins

Ingredients

2 tablespoon ground psyllium

1 tablespoon ground chia seeds

1 tablespoon ground linseeds

1 cup pear juice (from the canned pears)

¼ cup pumpkin seeds

¼ cup sunflower seeds

½ cup gluten-free rolled oats

600g gram tinned pears

1 teaspoon ground cinnamon

5 prunes (stones removed)

Method

  1. Grind up the psyllium, chia and linseeds in the food processor
  2. Add the pear juice, and let the mixture sit for 5 minutes to form a gel.
  3. Stir in the pumpkin seeds, sunflower seeds and oats, and pulse to break up the seeds.
  4. Combine with the tinned pears, cinnamon and prunes and pulse again
  5. Divide into 12 muffin cases, and bake for 35 minutes at 180˚C.
  6. Allow to cool fully before removing from tin.