Everybody poops. We may not like to talk about it, we generally hide behind closed doors to do it, but everybody does it and obviously, we need to do it to properly eliminate waste from our bodies. And truthfully, who hasn’t felt that sweet sense of relief when you empty your bowels easily and can walk away feeling a little lighter?
Some people even revel in the chance to sit down, take a few deep breaths, and maybe catch up on some reading (or just have a few minutes to hide from your children. Maybe.)
Whereas others, particularly young children, may find the hassle and potential struggle of having a bowel movement unappealing and will do everything they can to avoid hitting the loo, setting themselves up for discomfort and potentially bigger problems down the road.
It is generally pretty easy to self-assess your toileting success, but how do you know if your child is pooping properly?
From the time your new baby is placed in your arms, the tracking of poop begins! You are told to track wet and soiled diapers, with pretty clear guidelines on what constitutes “normal”.
95% of childhood constipation is known as “functional constipation”, meaning there is no specific structural abnormality or medical condition causing the constipation. However, if it is not treated properly, it can lead to structural changes in terms of sensitivity of the rectum and anus, setting up a vicious cycle of problems with pooping, making early recognition and treatment essential.
For many children, one experience of painful pooping can lead to them trying to withhold a bowel movement, which leads to further pain when they finally do empty the bowels, thus increasing their anxiety around toileting. For some children, they become so engrossed in their activities that they delay the urge to poop, which increases the size and dryness of the bowel movement, making elimination that much more difficult. And for others, toilet-training too early or with negative motivators can lead to a child delaying the urge to poop for as long as possible, again setting them up for constipation.
Although most cases of childhood constipation are not due to structural abnormalities, in cases where children have withheld bowel movements for some time, or occasionally even spontaneously, we can see what we call “dysynnergia” of the pelvic floor muscles, where instead of relaxing to allow a bowel movement to occur, the pelvic floor muscles contract, causing the anus to stay closed and resist the passage of poop, again leading to a cycle of constipation.
In addition to these factors, not getting enough high-fibre fruits, vegetables and whole grains, not drinking enough water, eating too much dairy (if an underlying sensitivity exists) and being too sedentary can all contribute to pooping problems.
As with most things, childhood constipation is best treated with a multi-pronged approach: