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Constipation in kids (fecal loading)
Hi Dr..My 5 years old girl was experiencing loose motion/constipation on off from last 5-4 months..Have checked with pediatric gastro and came to know that she has constipation ( fecal loading) in xray and suggested dulcolax suppository and movicol for 30 days.The night she had suppository she passed small hard formed stool with lots of pain.Next days she started pediatric movicol in 100 ml one sachet.. yesterday she passed small pebble like stool and today she passed small soft stool but problem is she is not telling to poop ..I have to make her sit 2-3 times after meals.She always told us before about pooping.Is something a problem..She is active and asks for food as well.She is telling us when she needs to pee but not for bowel movement..It's second only.Dr prescribed her with 30 days movicol.Her height is also increased only 1 cm in 5 months..Is her current gut issue the problem for that increase?
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Give child plenty of water .include seasonal fruits and vegetables in the diet .including green leafy vegetables like spinach and palak ir drum stick leaves will be very helpful .avoid all junk . Reduce milk .Include curd in diet .continue medication as prescribed.most important part is toilet training.give the child a glass of warm water .ask the child to sit in toilet for at least 10minutes every day at the same time in the morning even if stools not coming .continue training every day
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Greetings
Her reluctance to tell you about pooping is a classic stool-withholding behavior, caused by the memory of recent painful bowel movements.When a child retains stool, the stretched rectum temporarily loses its typical sensation of fullness.Continuing the prescribed Movicol is crucial to keep her stool soft and break this cycle of fear.Regarding growth, chronic constipation can occasionally affect appetite or cause minor growth slumps, though 1 cm over 5 months may simply be a normal individual variation.
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This is common in children with constipation. Because she had painful stools earlier, she may not feel the urge to pass stool normally for some time. Continue Movicol as advised, make her sit on the toilet for 5–10 minutes after meals, and encourage plenty of water and fruits. It may take a few weeks for her bowel habit to become normal. Her height is unlikely to be affected by constipation, but her growth should be checked regularly on growth chart .
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Monitor growth on growth chart evaluate further if growth remains slow
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Give her adequate sleep
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Hello,
You should continue the medications as prescribed to help regularize your child’s bowel habits and relieve constipation.continue them until your paediatrician gradually tapers and advises stopping them.
Make it a habit to take her to the toilet after meals to utilize the gastrocolic reflex, which naturally stimulates bowel movements and makes it easier for her to pass stools. Encourage a regular toilet routine, preferably before she leaves for school. Maintaining a stool diary can also help track her progress.
Praise and reward her for trying to use the toilet, and encourage her to tell you whenever she feels the urge to pass stools. Avoid scolding or forcing her.
Ensure she eats a diet rich in fibre, including plenty of fruits, vegetables, and whole grains, and encourage adequate water intake to help prevent constipation.
Regarding her height, it would be helpful to know her current height, weight, age, and the heights of both parents. A child’s height is influenced not only by nutrition but also by genetic and environmental factors. With these details, we can better assess whether her growth is appropriate for her age.
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Based on what you’ve described, this is actually reassuring. In children with fecal loading/constipation, the rectum becomes stretched and the normal urge to pass stool may temporarily reduce. As the bowel gradually empties with Movicol, it is common for children to stop telling parents they need to poop for a while. This usually improves over the next few weeks as the rectum regains its normal sensation.
Please continue Movicol exactly as prescribed for the full course and encourage toilet sitting for 5–10 minutes after meals (especially after breakfast and dinner), without forcing. Ensure adequate fluids and a fiber-rich diet.
Regarding her height, an increase of only 1 cm over 5 months is not necessarily abnormal, as children do not grow at a constant rate. Constipation itself usually does not affect height unless there is an underlying condition (such as celiac disease, hypothyroidism, or chronic illness) causing both poor growth and constipation.
If her constipation persists despite treatment, she develops weight loss, poor appetite, blood in stools, persistent abdominal distension, or her growth continues to be slower than expected, please follow up with your pediatric gastroenterologist for further evaluation.
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Dr. Bhatt Vivek Prafulchandra
Pediatrician
5 yrs exp
Rajkot
Consult with Pediatrician physically for further evaluation and treatment
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Dr. Venkatesh Badugu
Pediatrician
9 yrs exp
Hyderabad
This constipation is common as kids are pickup water takes less fibre Rich diet
So you need to give Fibre Rich food like banana apples
You need to give Toilet training daily morning for 30mins for 1 month
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Dr. Ankur Gupta
Pediatrician
12 yrs exp
Lucknow
It looks like habitual constipation common in this age group.
Can encourage more fibre rich diet like papaya museli and oats ensure hydration along with given meds. Have patience and child will show improvement in 2 weeks.
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