Understanding Childhood Constipation: A Growing Concern for Parents

Constipation has quietly become one of the most common yet underrecognized health issues among children today. While it might sound like a minor concern, chronic constipation in children can lead to serious complications if not addressed early. Dr. Anand Sinha, Director of Pediatric Surgery at Fortis, shares crucial insights into this growing issue—one that he not only treats professionally but also understands personally as a parent.

A Hidden Pandemic Among Children

After the COVID-19 pandemic, healthcare professionals around the world began noticing a different “C” affecting children: constipation. Nearly every second child visiting pediatric outpatient clinics today is struggling with symptoms related to constipation. Many of these cases are not straightforward and are often discovered only when complications arise.

What Is Childhood Constipation?

Constipation in children is not strictly defined by how often they pass stools but also by the consistency and ease of passage. If a child:

• Passes hard stools
• Has bowel movements less than three times a week
• Strains during defecation
• Needs help (like laxatives or enemas) to pass stools
  —then they may be suffering from constipation.

Importantly, just because a child goes to the toilet daily does not mean they are not constipated. Many parents overlook hard stools or incomplete evacuation, which may still indicate a problem.

Common Signs and Complications

Constipation doesn’t always present as difficulty in passing stools. It can show up in unexpected ways:

Gastrointestinal Issues

• Blood in stool due to fissures or rectal polyps
• Hemorrhoids, which are surprisingly now seen even in children
• Gastrointestinal infections like mesenteric lymphadenitis (painful lymph node swelling in the abdomen)

Urinary Problems

• Urine retention or dribbling caused by stool pressing on the bladder
• Infections due to incomplete bladder emptying

Surgical Emergencies

• Acute appendicitis, often triggered by a hard stool blocking the appendix

Growth and Developmental Delays

• Poor appetite
• Stunted growth or weight gain
• Even cognitive and behavioral issues due to unhealthy gut bacteria, which are now linked to brain health

Why Is It So Common Today?

According to Dr. Sinha, the main drivers of childhood constipation today include:

• Poor dietary habits: Excessive processed foods, refined flour, low-fiber meals, and high milk intake
• Inadequate hydration
• Sedentary lifestyles and excessive screen time
• Poor toilet habits: Children avoiding or rushing bowel movements due to distractions

In some rare cases, underlying conditions like Hirschsprung’s disease—a congenital issue where nerves are missing in parts of the intestine—could be the cause.

Prevention and Management

Fortunately, most cases of childhood constipation can be managed effectively with lifestyle changes:

Dietary Changes

• Increase fiber through fruits, vegetables, whole grains, prunes, and dates
• Encourage fluids like water, coconut water, and fresh juices
• Limit milk and switch to alternatives like curd or paneer
• Avoid refined flour and junk food

Healthy Habits

• Encourage children to respond promptly to the urge to defecate
• Ensure they spend enough relaxed time on the toilet
• Monitor consistency and frequency of bowel movements

Medical Support

If lifestyle changes don’t help, pediatricians may recommend:

• Laxatives (safe for long-term use under medical guidance)
• Topical creams for fissures
• Investigations like X-rays or ultrasounds in complicated cases
• Surgical consultation, if complications or rare conditions like Hirschsprung’s are suspected

Final Thoughts

Constipation is more than just a minor digestive issue. It can impact a child’s physical, emotional, and cognitive health if left untreated. As parents and caregivers, it is vital to pay attention to bowel habits, encourage a healthy lifestyle, and consult a pediatrician when needed.

Early recognition, timely intervention, and proper management can help children lead healthier, happier lives—free from the hidden burden of constipation.

Disclaimer:
This article is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your pediatrician or qualified healthcare provider regarding any health concerns.