Symptoms of severe pediatric constipation include hemorrhoids and anal fissures. If your child shows symptoms of pediatric constipation, monitor her closely. Seek medical attention if the problem worsens or becomes chronic.
Symptoms
A prolonged period of not passing stool, often for seven days or more at a time, is a common sign of more severe constipation in children. When your child does have a bowel movement, he typically will pass a small amount of extremely hard or pebble-like feces with difficulty. Over time, a refusal or inability to pass stool causes the feces to become impacted, which could lead to swelling and pain in the abdomen, accidental leakage of fecal matter in underwear and skin cracks in the anal region.
Causes
Abrupt changes in your child's diet or bathroom habits may lead to severe constipation. Common causes include a decrease in fluid or fiber intake. It sometimes occurs when a young child begins toilet training. The resulting painful defecation often prolongs and worsens the condition; the child resists passing stool because she doesn't want to experience the physical discomfort again. Certain medications and health conditions may also cause ongoing constipation, including hypothyroidism, celiac disease and some neuromuscular disorders.
Diagnosis and Treatment
Treatment for severe pediatric constipation varies depending on the underlying cause of the condition. Your pediatrician will typically ask about symptoms and the duration of the constipation before conducting a physical exam, which may include a rectal exam and palpation of the abdomen. In severe cases of pediatric constipation, the doctor typically focuses on dislodging an impaction and evacuating the stool. In many cases, dietary changes and stool softeners provide adequate follow-up treatment to help pediatric sufferers get through severe constipation; children with anal fissures may also require topical skincare treatment.
Considerations
Prevent severe pediatric constipation by recognizing bowel movement problems promptly. As soon as you notice signs of constipation, increase fluid and fiber intake. Minimize abrupt changes in routines, especially those involving the bathroom. If you've just started potty training, consider holding off on the training for a bit longer to allow your child's bowel movements to return to normal. Make a note on the calendar when you first notice symptoms; keep track of the duration and severity of the condition. As a rule, constipation that drastically worsens or lasts for more than two weeks warrants a trip to the pediatrician.
References
- "Textbook of Pediatric Emergency Medicine"; Dr. Gary Fleisher, et al.; 2010
- MayoClinic.com; Constipation Complications in Children; May 2011
- "Pediatric Gastrointestinal Disease"; Dr. W. Allan Walker; 2004
- "Maternity and Pediatric Nursing"; Terri Kyle, MSN; 2008
