Infant Constipation | Causes and Treatment of Constipation in Toddlers

Constipation in Infants

Constipation is characterized by reduced frequency of defecation and passage of dry hard stool.
Habitual chronic constipation may at times be followed by atonia of colon.

Babies on artificial feeding tend to be more constipated.
In others, inadequate feeds and insufficient water intake may be responsible.
The cause of constipation may not be always evident but the following causes must always be excluded in infants
- Congenital anomalies of the digestive tract, such as pyloric stenosis, congenital mega colon also called as Hirschsprung’s diseases and anal stenosis.
- Metabolic disturbance such as meconium ileus or congenital hypothyroidism has to be ruled out as a cause of constipation.

Causes of Constipation In older children

Use of low residue diet and faulty bowel training often result in constipation.
In judicious use of purgatives and enema make it worse.
Poor appetite and vomiting in febrile illness may lead to constipation.
A playful child may ignore “call to stools” and in course of time disregard the sensation of rectal fullness.
A child may avoid going to an unclean toilet and develop a habit pattern of ignoring rectal pressure.
Emotional problems may result in psychogenic constipation.
Constipation may also be feature of sub-acute intestinal obstruction.

Detailed history regarding constipation, bowel habits, toilet avoidance abdominal pain, febrile illness recently, use of purgatives has to be taken.
In case of suspicion
- Barium enema helps attaining diagnosis showing a relatively constricted aganglionic segment in recto-sigmoid distal to dilated colon in Hirschsprung’s disease.
- An X-ray plate of upper abdomen after barium meal shows dilatation and hypertrophy of stomach and delayed passage of barium through narrow pylorus thus supporting diagnosis of pyloric stenosis.

Parents should be reassured of the benign nature of simple constipation and child should be helped to develop normal bowel habits.
Increase the intake of fluids, use of high residue diets (whole wheat flour), fruits and vegetable.
Wetting agents such as sodium dioctyl-sulphosuccinate are useful adjuncts but have not been popular.
Use of liquid paraffin may be recommended in some cases.
Dulcolax rectal suppositories may also be used.
Senna preparations (glaxena) are popular as mild laxatives.
Lactulose solution 15-30ml at breakfast relieves constipation.
Child should be encouraged to use toilet regularly without hurry or distractions.
Any cause for painful defecation such as enterobiasis, proctitis or fissure should be looked for and managed.

June 28, 2009 | Filed Under Digestive Disorders

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