How to ease constipation in children

File photo: Many kids hold their bowels at school because they are uncomfortable going in such a busy, public setting.

File photo: Many kids hold their bowels at school because they are uncomfortable going in such a busy, public setting.

Published Mar 12, 2017

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There is an experiment that I have not yet tried with my children, mostly because they are not huge fans of beetroot. 

The experiment measures digestion health, which might appear uninteresting, but because boys (no matter what age) seem to love potty talk, I actually think it could be a big hit. The experiment asks kids to eat a big bowl of beets and then see how long it takes for the pink color to show up . . . you know where. The goal is to tell how efficient or sluggish their digestion is.

Tons of kids are constipated. Approximately three percent of general pediatric office visits are due to constipation complaints, and 25 percent of referrals to pediatric gastroenterologists are for constipation.

Many kids hold their bowels at school because they are uncomfortable going in such a busy, public setting. Others rush out the door in the morning, still half-asleep, not giving their bodies a chance to empty. Constipation can limit their activity and life enjoyment by triggering stomach pains, making it uncomfortable to run and play, initiating embarrassing gas, and messing with their meal intake, overall nutrition and daily energy.

Constipation, especially chronic, can be more than an aggravation, though; it can be unsafe. Large stools can stretch out the colon, irritate the colon walls, damage the good bacteria in the gut and produce toxins from wastes that have been sitting in the large intestine for too long. These troubles can trigger other health issues, such as body-wide inflammation, allergies, colon cancer and reduced emotional health.

A long time ago, Hippocrates said, "All disease begins in the gut." Considering that 70 percent of the immune system, which fights disease for our bodies, lies in and around the digestive system, he was on to something. When our gut becomes clogged, our health suffers.

What is normal?

Children should pass a bowel movement once or twice a day, or at minimum once every two to three days, without discomfort or pain.

How can you tell if your child is constipated?

Signs include:

- Hard, dry stools that are painful or difficult to pass.

- Days without a bowel movement.

- Abdominal pain.

- Cramping.

- Gas.

- Poor appetite.

- Crankiness.

- Frequent peeing or bed-wetting, because a large mass can put pressure on the bladder.

- Recurring urinary tract infections.

- Soiled underwear.

What causes constipation in kids?

- A typical Western diet including lots of cheese, pasta, bread, pizza, chicken nuggets and other foods that lack fiber.

- Lack of water.

- Lack of exercise.

- Withholding: when kids do not go when they need to.

- Certain medications.

- Illnesses.

- Stress.

- Changes in routine.

- Magnesium deficiency.

How can you help a constipated child?

- A fibre-rich diet: fruits such as apples and pears with the skins, oranges, berries and prunes; vegetables such as beets, broccoli, spinach and beans.

- Healthy fats such as wild fish, avocados, olive oil, flaxseed oil and coconut oil – toss pasta or vegetables with flaxseed oil or add 1 tablespoon to a smoothie.

- Ground flaxseeds and chia seeds – add to smoothies or sprinkle over oatmeal, yogurt, cereal or salads.

- Lots of water.

- Whole grains, as opposed to refined grains.

- Warm mint or ginger tea.

- Warmed fruit nectar.

- Molasses, which, because it has magnesium, can stimulate the bowels – add to smoothies and cereals.

- Probiotics.

- Vitamin C.

- Temporarily limiting dairy and gluten in the diet.

- Massaging the abdomen.

Why not give children a commercial laxative?

Commercial laxatives, such as MiraLax, are not approved by the US Food and Drug Administration for children and are recommended for adults for no more than seven days. The active ingredient in these medicines is polyethylene glycol 3350 (PEG 3350), which is a derivative of petroleum and is therefore essentially a plastic.

In 2014, the FDA awarded a grant to the Children's Hospital of Philadelphia to study whether PEG 3350 is absorbed into the blood by children and whether it contributes to neurological or behavioral problems such as seizures, tics, headaches, aggression, rages, obsessive compulsiveness, anxiety and kidney problems. 

The natural remedies for constipation listed above might be preferable until more is ascertained from this study. Or, quite frankly, that big bowl of beetroot might just do the trick.

Washington Post

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