Constipation

The child sits on the potty or toilet for a long time several times a week and/or is rarely or never able to defecate. The stool is hard and very large quantities are often passed. The child usually suffers from abdominal pain or flatulence. Loss of appetite and fatigue can be further signs of constipation.

As the child tries to avoid pain during bowel movements, it is not uncommon for them to deliberately hold them back. To do this, children sit on their anus, hold their hand in front of it, or tensely paw back and forth.

Constant defecation and involuntary defecation can also be signs of constipation, as overflowing of still liquid stool occurs - so-called paradoxical diarrhoea in constipation.

If you have observed two or more of the following symptoms in your child for at least one month, you have chronic constipation:

• less than three defecations per week.
• more than one episode of faecal smearing per week.
• Stool masses can be felt in the rectum or abdomen.
• Retention of the bowel movement.
• painful defecation or hard stool consistency.

In 95 per cent of all children there is no organic disease. There are many reasons for a hard stool. The following triggers can be at the beginning of constipation:

• a survived gastrointestinal infection.
• Stressful situations.
• a small amount to drink.
• little fibre in the diet.
• little everyday movement.

You should consult a doctor at the first sign of abdominal pain and a low frequency of defecation (less than three bowel movements per week). The longer the constipation persists, the more difficult it is to treat. In addition, chronic constipation also means a massive reduction in your child's quality of life.

Firstly, your child will undergo a thorough physical examination so that physical causes for the constipation can be ruled out. If this is the case, your child will be prescribed a laxative to completely empty the bowel and then a so-called stool softener. This has the effect of binding the water in the stool so that it remains soft and defecation no longer hurts.

In addition, toilet training is also very important in order to get the problems with elimination under control in the long term. You should regularly sit your child on the potty or send them to the toilet after every meal. This training should be carried out consistently in order to train regular elimination. A reward system is helpful here. Toilet training requires a lot of patience, as it often takes months for elimination to completely normalise.

The correct posture or sitting position on the toilet can also make defecation easier. As shown in the illustration below, your child should sit upright on the toilet and tilt their upper body slightly forwards so that there is a bend in the hip joint. The hands can be supported on the thighs and the legs should be placed on a stool. The pelvic floor can relax optimally in this position.

Fibre from fruit, vegetables, nuts and pulses is very helpful for a well-functioning gut. However, the effectiveness of dietary fibre should not be overestimated. If the two central therapeutic steps - bowel evacuation and toilet training - are not implemented consistently, a diet very rich in fibre is of little help.