CONSTIPATION |
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DESCRIPTIONConstipation means difficult or uncomfortable bowel movements. The colon and the entire intestinal tract are involved.
Appropriate health care includes: self-care after diagnosis; physician's monitoring of general condition and medications (occasionally).
SIGNS & SYMPTOMS
Children vary widely in bowel activity. Any of the following may be a sign of constipation:
Infrequent bowel movements, sometimes accompanied by abdominal swelling.
Hard feces.
Straining during bowel movements.
Pain or bleeding with bowel movements.
Sensation of continuing fullness after a bowel movement.
CAUSES
Inadequate fluid intake.
Insufficient fiber in the diet. Fiber adds bulk, holds water, and creates easily passed, soft feces.
Inactivity.
Hypothyroidism.
Hypercalcemia.
Anal fissure.
Depression.
Chronic kidney failure.
Back pain.
RISK FACTORS
Stress; illness requiring complete bed rest; use of certain drugs, including belladonna, calcium-channel blockers, beta-adrenergic blockers, atropine, aspirin, or anti-convulsant drugs.
PREVENTING COMPLICATIONS OR RECURRENCE
Your child should eat a well-balanced, high-fiber diet.
Encourage the child to exercise regularly.
Urge the child to drink at least 8 glasses of water a day.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms. Tell your doctor of any major change in your child's bowel pattern that lasts longer than 1 week. It may be a sign of cancer.
Medical history and physical exam by a doctor; laboratory tests of blood and stool to detect internal bleeding; sigmoidoscopy (See Glossary).
POSSIBLE COMPLICATIONSHemorrhoids; laxative dependency; hernia from excessive straining; uterine or rectal prolapse; spastic colitis.
PROBABLE OUTCOME
Usually curable with exercise, diet, and adequate fluids.
TREATMENT
HOME CARE
Set aside a regular time each day for your child's bowel movements. The best time is often within 1 hour after breakfast. Don't try to hurry the child. Encourage the child to sit at least 10 minutes, whether or not a bowel movement occurs.
If constipation persists for 3 or 4 days, use a non-prescription, disposable enema for temporary relief. If you prefer not to use a commercial enema preparation, you may give your child an enema as follows:
-- Spread a bath mat on the bathroom floor or in the tub.
-- Fill an enema bag with lukewarm water.
-- Hang the enema bag no higher than 30 inches from the floor.
-- Have the child lie on the left side on the mat.
-- Insert the lubricated nozzle gently inside the child's rectum.
-- Let the water flow in slowly, a little at a time. If it hurts, stop the water flow until the pain subsides. Then start the flow again.
-- Use the entire quart of water.
-- Encourage your child to hold the fluid inside until the child feels uncomfortable. Then the child can sit on the toilet for a bowel movement.
MEDICATION
For occasional constipation, give your child stool softeners, mild non-prescription laxatives, or enemas. Don't give the child laxatives or enemas regularly -- this can cause dependency. Avoid harsh laxatives and cathartics, such as epsom salts.
ACTIVITY
Exercise and good physical fitness help maintain healthy bowel patterns. See Appendix 36 for exercise suggestions.
DIET & FLUIDS
Encourage your child to drink at least 8 glasses of water each day. Include bulk foods, such as bran and raw fruits and vegetables, in the family's diet. Avoid serving refined cereals and breads, pastries, and sugar.
OK TO GO TO SCHOOL?Yes.
CALL YOUR DOCTOR IF
Your child has constipation that persists, despite self-care--especially if the constipation represents a change in the child's normal bowel patterns.
Your child's constipation is accompanied by fever and severe abdominal pain.
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