Let us talk about stooling patterns in children. This topic is often taboo in society, but a healthy stooling pattern especially in children plays a very important role in maintaining overall good health. Morale of the story; we should be asking our children more about their stooling pattern.
“Constipation” is a familiar term for many and is often described as the inability to go to the bathroom. In reality however, the concept of constipation is not this simple. Constipation, according to scholars, is known as hard and seldom bowel movements that often go together with abdominal pain and bloating. Furthermore defining constipation in your child also depends on whether they are older or younger than four as well has for how long they have been struggling to go to the bathroom. The tool or criteria that health care professionals use to define constipation is known as the Rome IV criteria.
ROME IV criteria used to define constipation2
| INFANTS TILL 4 YEARS OF AGE | 4 YEARS TO 19 YEARS OF AGE |
| Must have more than two of the following for more than one month:
– Less than 2 stools per month – A history of painful or hard bowel movements – A history of excessive stool retention – History of passing a large stool – Presence of a large stool mass in the rectum – More than 1 episode of soiling undergarments per week – History of a large diameter stool that can obstruct the toilet
|
Must have more than two of the following for more than one month:
– Less than 2 stools per month – A history of painful or hard bowel movements – Presence of a large stool mass in the rectum – Behavior of withholding stooling – History of a large diameter stool that can obstruct the toilet
|
The cause of constipation in children can be multi-faceted and therefore visiting your doctor is essential. Some underlying causes of constipation are:
- Environmental conditions: Unpleasant or unfamiliar toilet facilities away from home. A child may also easily withhold from stooling as they don’t want to disrupt their playing time.
- Stress: Stressful situations, where painful or frightening stooling occurred, even if just a single event, can bring about constipation. Other known causes of constipation is the presence of anxiety especially when “potty” training.
- Diet: Maintaining a diet low in fiber and fluid may result in constipation. Nutritional imbalances may also aggravate constipation.
The presence of constipation can greatly influence nutritional well-being. Studies have reported that constipation can negatively influence growth as children often develop nausea and abdominal discomfort resulting in a decreased appetite and avoidance of food.2,3 This in turn leads to adapting to a diet that lacks variety and key nutrients that promote growth and development. Early identification of constipation as well the management is therefore vital to ensure health promotion. Book an appointment with us, to learn more about constipation and dietary strategies aimed at reducing its occurrence.
REFERENCES:
- Allen, P., Setya, A. and Lawrence, V.N., 2020. Pediatric Functional Constipation. StatPearls [Internet].
- Vriesman, M.H., Koppen, I.J., Camilleri, M., Di Lorenzo, C. and Benninga, M.A., 2020. Management of functional constipation in children and adults. Nature Reviews Gastroenterology & Hepatology, 17(1):21-39.
- Yousefi, A., Mohamadian, S., Sharifabadi, P.M., Nakhaei, S. and Norouzi, E., 2019. How does functional constipation affect growth status in children?. Iranian Journal of Pediatrics, 29(2).
