Helping kids of all ages to live a more active life through FUNctional movement.
Constipation is defined as inadequate defecation/elimination characterized by infrequent stools, difficult stool passage, or both (1). Generally this means fewer than 3 bowel movements per week.
This is a problem that affects up to 30% of children worldwide.(6) Sadly this problem accounts for about 5% of ALL trips to the doctor…with all the possible problems a child could have, this is a HUGE problem!
There are many possible signs of constipation. Often in children we see these:
To classify the problem, the Rome IV Criteria is used. (The Rome Foundation is an organization that helps to improve the lives of people with functional GI disorders).(4) They use different criteria for children under 4 years of age, and over 4. To be officially diagnosed as having chronic constipation, your child needs to have had at least two of the criteria on the list below for at least one month (1, 2)
For children younger than 4, the signs are:
For children over the age of 4, the list is as follows:
For children, there are two types of constipation: functional and organic. Organic means that there is a problem with your child’s body structure. This could be a specific structural, neurologic, toxic/metabolic, or intestinal disorder. These are rare, but still exist (only about 5% of the time). Functional constipation occurs about 95% of the time; obviously this is FAR more common. We’ll get into more details shortly.
Oh boy, where do we start? There are so many possible contributing factors. Here are some possibilities:
Many children with chronic constipation have had this problem for far longer than one month, and have been told to take PEG (Polyethylene glycol) as a means to deal with the problem, with no plan in place for normal function. But did you know that PEG is NOT A SOLUTION to the problem? It is a means of managing the problem; an expensive one. One that doesn’t address the root cause of the constipation in your child. And good luck if your child refuses to take it… then what? Luckily there are other solutions that can help your child’s constipation, such as physiotherapy with a pediatric therapist, or even chiropractic or osteopathic treatments. In this article we focus on physiotherapy, but just know, there are many therapists with pediatric experience and specialties that can support you child.
Wait! What? Physio can help your child get on-track with pooping? Well…do bears poop in the woods? Yes… the answer to both questions is YES!
The first step to helping is a comprehensive assessment. During this, your physiotherapist will ask you and your child a LOT of questions about your current lifestyle (diet, water consumption, exercise habits, daily activities, toileting habits, anxiety, etc.). Then they will look at your child’s posture in more detail. They will get your child to do a number of physical tests like testing core strength, one foot balance, and a whole bunch of ‘weird’ activities (if we’re testing for primitive reflexes, a contributing cause of constipation). Basically, we’re looking at your child’s body for alignment and how it functions (or doesn’t).
Once the assessment is complete, the physiotherapist will provide a comprehensive treatment plan, that may include core strengthening, reflex integration, posture and breathing exercises and will usually include keeping a diary of certain things for 3 days, and possibly modifying food and hydration choices. You will follow-up with the physiotherapist regularly, and as your child makes changes, the program will be modified to ensure continued progress. Your therapists may also refer you to work with a chiropractor or osteopath, if they feel there are other things to address.
Need more information or aren’t sure yet if your baby, toddler or child is constipated?
You can book a complimentary 15 minute consultation with one of our therapists with pediatric experience right here at Play On Pediatric Therapy in Barrhaven (south-west end of Ottawa) to see if they can benefit from physiotherapy for chronic constipation.