Constipation in children has reported prevalence rates between 1% and 30%. It is the principal complaint in 3 – 5% of all visits to pediatric outpatient clinics and as many as 35% of all visits to pediatric gastroenterologists. Constipation is generally defined as a delay or difficulty in defecation, present for 2 weeks or more, and sufficient to cause significant distress to the patient.

Here are some frequently asked questions on kids constipation from parents.

Q: Does increasing dietary fibre help with constipation?

Fibre is the part of food that is not fully digested by human digestive enzymes. Dietary fibre has a sponge-like effect within the bowel, absorbing water as it passes through the intestine, thereby increasing the bulk of the stool, making it soft and easy to pass.

High fibre foods suitable for children include:

• All fruit, including soft dried fruit like raisins
• All vegetables
• Baked beans on wholemeal toast
• Red kidney beans, 3 bean mix or chickpeas added to salads and casseroles
• Breakfast biscuits. Also try as a snack spread with cream cheese or peanut butter
• Oats, porridge
• Wholemeal crackers eg: wheatmeal or oatmeal
• Nuts and seeds (for older children)
• Wholemeal varieties of pasta and rice

All unprocessed brans (wheat, rice, oat) are too high in fibre and are not suitable for young children due to bloating and wind. Too much unprocessed bran can also interfere with absorption of other essential nutrients important for growth, such as calcium.

Q: Does fruit juice help?

In infants older than 6 months, juices containing sorbitol, such as prune, pear and can decrease constipation. However, too much fruit juice can cause diarrhea, bloatedness, abdominal pain, obesity and dental caries.

Q: Will my child become dependent on the medications once he starts taking them?

No. The laxatives are not addictive nor do they cause the bowels to be lazy. However, premature termination of treatment causes chronic constipation to recur, perpetuating the myth that the child is ‘dependent’ on medications. Chronic constipation may psychological issue, with many children being very fearful of embarrassment and pain. Occasionally, psychosocial issues may worsen the constipation and may need to be treated concurrently or constipation will not resolve.

These questions were answered by Dr Nancy Tan, Paediatrician at SBCC Baby and Child Clinic.

This article was first published in The New Age Parents e-magazine.

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