constipation in children

35% Malaysian suffer from constipation in silence. Many feel it is an embarrassing condition and refused to talk about it. 

Constipation is: 

  1. A bowel movement is performed less than three times a week 
  2. Stools are hard and often in pallet form; it is difficult or impossible to pass without straining 
  3. Experience no satisfying feeling of emptiness on leaving the toilet 

Prevalence of constipation varies according to age groups. The peak of constipation occurs between 2 to 4 years of age, when the potty training starts. 

Children at risk of constipation  

1. Lacking of physical activity 

For many children, computers, television, tablets or iPad, or smartphone have taken the place of active play. Increasingly, children choose to stay inside rather than go outside to play. Physical exercise (cycling, running) contributes to stool motility and the frequency of bowel movements. If your child does not get enough physical exercise, he or she is more likely to become constipated. 

2. Ignore the sensation to the loo 

Some children get so engrossed or hyper-focused while playing “screen” games that they ignore the need to go to the toilet. The more they do this, the more their stool dries and hardens, making it more difficult for them to have a bowel movement whenever they decided to go to the toilet. 

3. Not eating enough of dietary fibre 

Recently fast food has become the food of choice for children. Children also often reject whole grain cereals, bread, leafy greens, vegetables, and fruit in favour of sugary, refined cereals, snacks, and greasy fast food. Instead of snacking on fruit and veggies, they are more likely to be eating packaged chips or cookies, which tend to be low in fibre, but high in fat. 

4. Not drinking enough of liquid 

Dehydration is one of the most common causes of constipation. The food you eat makes its way from stomach to the large intestine. If you do not have enough water in your body, the gut reacts by extracting more water from the food passing through it. That makes feaces harder. Small children running high temperatures often lose so much body fluid through sweating that their digestive system grinds to a halt. 

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Little tricks to prevent constipation 

1. Nutrition is the key 

There is a certain foodstuff we can eat to nudge the gut wall into action: FIBRE. Dietary fibre is not digested in the small intestine, and can knock on the wall of large intestine in a friendly way. It also helps to draw extra fluids into the gut, making the whole business smoother. 

There are two kinds of fibre: water-sluble and insoluble. The latter is better at stimulating movement through the digestive system, but can often cause stomachaches. Water-soluble fibre does not provide quite such a powerful push, but it does make the contents of the gut softer and easier to deal with. 

Nature’s design is rather cleaver: the skin of many fruits contains large amount of insoluble fibre; while the flesh of the fruit contains more soluble fibre. Therefore, eating the whole fruit would be ideal. 

2. Fluid is equally essential

Consuming dietary fibre is little help if you do not also consume sufficient fluids. Without the presence of water, fibre binds together in solid lumps. Water makes them swell up into balls which makes the passage a smoother journey. 

Drinking more fluids can only help those who do not already drink enough. For those who do, drinking even more will not bring about any improvement. 

3. Do not put yourself under pressure

If you need to go to the toilet, just go! When the urge is suppressed due continuing video or iPad games, you might have broken an unspoken agreement with the gut. The gut likes to work according to plan. Pushing digested food back into the holding pattern even just a couple of times trains the nerves and muscles to operate in reverse gear. That can make it increasingly difficult to change gears back again. 

This is compounded by the fact that the longer the stool stay in the gut, the more time the body has to extract fluid from them, making the business ever harder. 

4. Probiotics 

A living, beneficial bacteria and their favorite food that can breathe new life into a tired gut. To make any difference to the huge ecosystem in the gut, about a billion (109) probiotic bacteria need to make it through the system and arrive there intact.

Yakult is a type of probiotic drink. Every bottle of Yakult contains at least 30 billion (3×1010) probiotic bacteria, Lactobacillus casei Shirota strain. This bacteria is scientifically proven to help regulate bowel movement. Taking a bottle of Yakult probiotic drink everyday may help to prevent constipation. 

5. Get active! 

A sudden decrease in exercise can cause the gut to slow down. If you are already doing enough exercise, more movement will not help to increase motility of the intestines. However, by just taking more walks may not always be a successful strategy to prevent constipation.  Tests have shown that it takes extremely strenuous exercise to achieve a measurable effect on the movement of the gut. 

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The SHAPE and SHADE are good indicators of your intestinal health

Bristol stool chart interprets the shape of the stool while the colors give further insight about your intestinal health

The Bristol stool chart gives an idea of how long a stool spent in your bowel before heading out.

1. Separate hard lumps, like chocolates

You might not drink enough of fluids and lacking of fiber. Drink more water and ear more greens and fruits.

2. Sausage-shaped but lumpy 

Not as serious as separate hard lumps, but you need to increase your water intake.

3. Sausage-shaped but with cracks on surface 

This is normal but the cracks mean you could still increase your water intake.

4. Sausage-shaped, smooth and soft

Perfect poo! You are doing fine!

5. Soft blobs with clear-cut edges

Not too bad. Quite normal if you are going to the toilet multiple times a day.

6. Fluffy pieces with ragged edges, a mushy stool 

You are on the edge of normal, it might easily turn into diarrhea.

7. Watery, no solid pieces, all liquid

You are having diarrhea! It could be due to infection with too much of bad bacteria in your intestines. Make sure you drink lots of liquid to replace the liquid lost to prevent dehydration. You can also opt for Yakult to reduce bad bacteria in your body!