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Constipation in children: do not wait long!


If the child suffers from constipation: Do not wait, but go quickly to the specialist
The bowel movement works only in pain and becomes a painful procedure: Five percent of all children between the ages of 1 and 5 suffer from chronic constipation (constipation). According to the Society for Pediatrics, Gastroenterology and Nutrition, this is a common problem that is too often underestimated. It has been a perennial favorite in every German practice for years. Parents go to the specialist too late and, out of ignorance, only rely on more exercise and drinking. "Only early treatment is successful and prevents chronification in adulthood with a loss of quality of life," Dr. Stephan Buderus, chief physician pediatrics at Marien Hospital in Bonn and Dr. Axel Enninger, Medical Director of the Center for Pediatric, Adolescent and Women's Medicine at the Stuttgart Clinic.

The two members of the society answer the important questions:

What are the symptoms of chronic constipation?
The child sits in pain on the potty or the toilet several times a week for a long time and rarely or not at all can empty the intestine. The chair is hard and big. This procedure is accompanied by stomach ache and bloating. Loss of appetite and fatigue are other indicators that parents should watch out for. Of course, if the child can only do big business in pain, it tries to avoid it. It deliberately holds back, covers the anus with your hand and taps back and forth tense. The symptoms are complex and not always clear. Constant defecation and involuntary bowel movements can be signs of a paradoxical diarrhea in constipation.

Can a dangerous illness be the cause?
The good news: 95 percent of all children have no organic illness. There are many reasons for a hard bowel movement, because a surviving gastrointestinal infection can be as much a trigger as stressful situations in the child's everyday life. This may be the loss of the familiar environment, pressure at school, the separation of parents, the death of a loved one, or even unusual events that the child literally digests badly. A genetic predisposition can also be the cause.

When should parents and their child go to a specialist?
Constipation is a painful process for every child. The parents are insecure and often do not know what their child is missing. Out of ignorance, they increase the amount of drinking or rely on more exercise. That alone is not enough. Therefore, at the first signs of abdominal pain, cramps and, above all, problems with the big business, quickly consult a specialist for gastrointestinal diseases. He provides professional information and ensures effective treatment that is now important. Waiting can lead to chronicity into adulthood. This means a massive reduction in the quality of life with difficulties in social and intimate contacts. This is a vicious cycle that can only be broken through early treatment. Parents need support from a specialist because they are legitimately worried and see daily how their child is suffering. This toilet stress for children and parents must be avoided.

What is the right treatment?
The anus is carefully examined during the examination. This is uncomfortable for the child - but this is the only way to rule out organic causes. The child then receives medication that must be taken orally. They ensure complete emptying of the intestine. This is an incredible relief for any child who has often had constipation for weeks. Finally, the bowel movement doesn't hurt anymore. However, medication must be administered over several weeks, especially in the case of chronic constipation. Laxatives such as macrogol powder ensure that the stool mixes more with water and remains soft. The aim of the treatment is to completely empty the intestine. In difficult cases, we advise you to have a "consultation hour" in which a multi-professional team is involved. With the right treatment, the success rates are almost 100 percent!

How useful is stool training?
In addition to the administration of medication, chair training is a valuable aid in getting long-term problems under control with the big business. The Society for Pediatric Gastroenterology and Nutrition recommends that parents place their child on the potty or toilet regularly after each meal. This training in a quiet environment must be carried out consistently, because it is a kind of bridge back to normal. It is also important to have a reward program for the child in successful business - of course not with cookies or chocolate. Because chair training is also a challenge for the child: it can take months for the digestion to function normally again. Parents need perseverance and patience. Because in stressful situations, there can again be problems with digestion. Therefore, always remember that it does not work because the child cannot but wants to.

What role does nutrition play?
For a fit intestine, fiber such as fruits, vegetables, nuts and legumes are recommended. Parents receive this information when they are looking for help on the Internet, logging into chats, or receiving supposedly good advice from friends. There is a confusing amount of good advice. However, our practical experience shows that the effectiveness of fiber is often overestimated. In addition, they are often not accepted by children. We recommend a normal mixed diet and sufficient physical activity. The amount of drinking is also overestimated. Therefore, seek professional support from a pediatric gastroenterologist. If constipation begins early, the exclusion of a cow's milk allergy through a diet attempt is always part of the process. In addition, parents should critically review how many constipating foods such as banana, cocoa and fast food are on the diet.

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Video: Functional Constipation by Piyawat Sukijthamapan for OPENPediatrics (January 2022).