Toddlers and Childhood Constipation - A growing problem

When a child complains it is painful to go to the toilet, it must be taken seriously. The child may subconsciously hold back the stool to prevent a painful evacuation. As they accumulate in the rectum, only watery stools manage to get through, often by accident - the child may appear to have diarrhoea but it is actually caused by "overflow" constipation. This could leave the remaining stools even drier, harder and more painful to pass.

Childhood constipation can be caused by diet, lack of fluid intake, illness or medication, but there may also be emotional reasons: potty-training - trauma at this time can start the habit of becoming nervous or stressed nursery or school - it can be quite worrying when starting school to have to use a noisy, unfamiliar school toilet, so it's no surprise when children decide to wait until they get home

How to treat

For whatever reason, a child may refuse to go to the toilet, or lie about having already been. Of course the longer children leave going to the toilet, the more painful it can be when they finally do go and this can put them off going again. Children pick up parents' anxiety, so it is important not to appear worried.

If your child is affected, try to make the same lifestyle changes as you would for yourself by getting him/her to:

• eat more fibre
  every parent knows how picky children can be about what they eat, so sneaking high-fibre foods into their diet requires some ingenuity. That said, you should try not to make a behavioural issue out of eating - food should remain a pleasure
• drink more water or juice
• take more exercise
• cut down on high-fat and high-sugar content foods
• encourage regular bowel habit
  setting aside a specific time of day to go to the toilet, such as after breakfast or the evening meal, will teach your child not to put off bowel movements and may help to establish regular habits. A footstool can put the toilet at a comfortable height, while putting out storybooks or comics may help them relax and take their time.

Children's Constipation Remedies

It's hard to sit by while your child is suffering, so if necessary a gentle constipation remedy can be given.

Children over 12 years may take two 5ml spoonfuls of Senokot syrup in 24 hours which can bring effective, predictable relief.

Children under 12 should only be given Senokot syrup on medical advice, when recommended the dose is as follows:
- children aged 2-6 half-one 5ml spoonful of Senokot syrup and
- children aged 6-12 one 5ml spoonfuls of Senokot syrup in the morning.
(contains senna - always read the label)

If your child prefers to take tablets then Senokot tablets can be taken by children aged 12 or over. Two-four Senokot tablets should be taken at night. (contains senna, always read the label)

Lack of fibre is a common cause of constipation and it can be difficult to get a child to eat enough fibre. Your child's diet should be the first thing you address. Fybogel is a suitable remedy for treating constipation in children.
Children 12 and over may take one sachet or two level 5ml spoonfuls in the morning and evening.
Children aged 6-12 take may take half to one level 5ml spoonful, depending on age and size, in the morning and evening.
Under medical supervision children under 6 years can take half to one level 5ml spoonful, depending on age and size, morning and evening
(Contains ispaghula husk - always read the label).

Talking about the problem

It's important to explain to your child why you're changing their diet or giving them a constipation remedy, and to tell them when the remedy might start to work. Most children won't talk about their bowel habits or their constipation, even to close friends. And many parents also keep the subject to themselves. But it's crucial children don't feel constipation is their fault.

Your GP, health visitor, nurse or pharmacist can offer support and will try to reassure you that the problem is very common and that there are practical solutions.