Constipation

Even in those with otherwise regular bowel movements, acute constipation can occur if we get out of our normal habits. It may happen on vacation or any time we get off schedule. If we are unable to hydrate well, not able to eat our normal diet or we are unable to get movement regularly, stool irregularity will result. 

Establishing the regular habit of hydrating well, eating a plant-based high fiber diet and getting exercise will get things back into order. Fiber helps move things along. Exercise and hydration are extremely important to gut health.

All plant-based foods have fiber while animal foods do not have fiber. Meat and dairy are high in fat and do not contain fiber. Increased high fiber plant foods and decreased low fiber animal foods makes for more regularity.  A plant-based diet with a good variety of fruit, vegetables, whole grains, legumes seeds and nuts has been shown to promote gut health as well as overall health. After the first year of life, 5-10 fruits and vegetables a day are optimal.

For optimal hydration, adequate water intake is needed throughout the day. By the time a child reaches 100 pounds 6 to 8 glasses of water a day is recommended. More with prolonged exertion and heat.

Children and adults alike should get physical activity daily. Movement helps with peristalsis. Physical activity builds muscle which boosts metabolism. Mental and physical health benefit from regular exercise and time outdoors.

Over the last few decades more and more children as well as adults are suffering from chronic constipation. Invariably, the cause of this is lifestyle choices. - Eating fast food which is usually very low in fiber and high in fat. Not drinking enough water and drinking sodas with caffeine. Not getting adequate activity.

Caffeine drinks contribute to dehydration and constipation. Children should not drink coffee drinks or sodas. Not only does this caffeine cause problems with constipation, it interferes in calcium balance and bone growth and contributes to poor nutrition. Sodas and coffee drinks may increase calories beyond optimal for the day. They are empty calories, replacing nutrition.

Increasingly the diagnosis given to children going to the ER for stomach aches is constipation. They will often obtain an xray showing an enlarged colon full of stool. By far and large the cause is lack of water, fiber and activity.  

Fast food meals for breakfast, lunch and dinner are not uncommon in a standard American diet. Many may have an Egg McMuffin for breakfast, burger and fries at lunch, pop tart  for a snack and a pizza dinner with a couple of sodas thrown in. The fiber in this diet is low, the nutrition poor and the fat high. Water intake is often low.

Even a “healthy” diet with yogurt and granola breakfast, whole-grain sandwich and sun chips for lunch and pasta, bread and a small salad for dinner has far fewer than 5 servings of fruit or vegetables a day.

Some may have slower transit times. It often runs in families. Parents will report that they and many relatives seem to suffer constipation from youth.  Much of this is lifestyle choices perpetuated in the family. Whether genetics or choice, it is very important to work on finding a healthy diet to regulate the bowel movements. 

Chronic constipation leads to stretching out the descending colon such that it’s floppy and doesn’t work properly. If the muscle of the descending colon is not contracting properly it’s more difficult to efficiently evacuate the stool. The longer the stool sits in the descending colon the more water is reabsorbed and the harder it will be to push the stool out. It becomes a vicious cycle.

Often families will not recognize this as a significant problem in a child until they are having recurrent stomach aches. It may even get to the point that the child is so constipated that they are leaking liquid stool around hard stool in the descending colon. This condition, called encopresis, is messy, smelly and very distressing for child and parent alike. Once your child gets to this point it’s very difficult and time-consuming to cure. It’s very important to prevent this.

Without dietary and lifestyle change many will need added fiber and even laxative use on a regular basis until the gut recovers.  Work with your provider on a long term plan to recover and maintain normal bowel habits. Longer use of stool softeners or laxatives may be required when the constipation has been long standing. The muscle of the descending colon needs to recover elasticity and strength and proper contraction for proper function. Regular use of an osmotic laxative to produce soft solid stools on a regular basis may need to be undertaken for several months until stools are regulated.

To avoid chronic constipation make sure you and your family get at least 5-10 fruits and vegetables a day. Add dried fruits as needed. Eat whole grains. Include fermented foods to replenish the microbiome. Avoid refined grains and processed foods. Hydrate well. Adequate hydration is essential for overall health and a healthy gut. Encourage children to drink water before and between meals. Send reusable bpa free water bottles to school, work and all activities. Make sure physical activity is part of every day. Provide adequate opportunity and time to fully evacuate stool.

Overall health starts with the gut. It does require an investment in time, energy and resources to maintain. But it makes the difference between sickness and health.