It is not uncommon for children with reflux or
GERD to also suffer from chronic constipation which can unfortunately,
really make reflux episodes worse. Constipation means that bowel
movements are hard and dry, difficult or painful to pass, and less
frequent than usual. It is a common problem for children, but it is
usually temporary and no cause for parents to be concerned.
When a child does not eat enough fiber, drink enough liquids, or get
enough exercise, constipation is more likely to occur. It also happens
when children ignore the urge to have a bowel movement, which they often
do out of embarrassment to use a public bathroom, fear or lack of
confidence in the absence of a parent, or unwillingness to take a break
from play. Sometimes constipation is caused by medicines or a disease.
Symptoms of constipation include
- no bowel movement for several days or daily bowel movements that are
hard and dry
- cramping abdominal pain
- nausea
- vomiting
- weight loss
- liquid or solid, clay-like stool in the child's underwear—a sign
that stool is backed up in the rectum
Constipation can make a bowel movement painful, so the child may try to
prevent having one. Clenching buttocks, rocking up and down on toes, and
turning red in the face are signs of trying to hold in a bowel movement.
Treatment depends on the child's age and the severity of the problem.
Often eating more fiber (fruits, vegetables, whole-grain cereal), drinking
more liquids, and getting more exercise will solve the problem. Sometimes
a child may need an enema to remove the stool or a laxative to soften it
or prevent a future episode. However, laxatives can be dangerous to
children and should be given only with a doctor's approval.
Although constipation is usually harmless, it can be a sign or cause of
a more serious problem.
A child should see a doctor if:
- episodes of constipation last longer than 3 weeks
- the child is unable to participate in normal activities
- small, painful tears appear in the skin around the anus
- a small amount of the intestinal lining is pushed out of the anus
(hemorrhoids)
- normal pushing is not enough to expel stool
- liquid or soft stool leaks out of the anus
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