Constipation is one of the most pressing concerns of parents today with all children no matter what the diagnosis or condition. Chronic diarrhea can often be the flip side to chronic constipation because the bowels may be so impacted that only liquid waste can come out.
Not having regular daily healthy bowel movements can lead to an array of symptoms in children such as:
- Abdominal pain
- Pain while having a bowel movement
- Blood in the stool
- Lack of appetite
- Hard stools
- Behavioral problems
- Mood problems
According to Dr. Timothy Buie, pediatric gastroenterologist at Harvard Medical School’s Boston, Massachusetts’s Hospital, 70% of children on the autism spectrum struggle to have daily bowel movements. Indeed, chronic constipation and/or chronic diarrhea are exceedingly common in children who later develop:
- Sensory Processing Disorder
- Autoimmune disorders
- Mood disorders
What Your Doctor May Tell You About Constipation
Your child’s doctor may prescribe a laxative such as MiraLAX for your child’s constipation. However, laxatives are not to be used for long periods of time or as a substitute for a medical work-up if your child has chronic constipation due to leaky gut issues and other gastrointestinal problems.
In addition, in December 2011, the U.S. Federal Drug Administration (FDA) placed laxatives containing Polyethylene Glycol 3350 (PEG) on its Adverse Event Reporting System (AERS) in connection to neuropsychiatric events. These PEG laxatives are marketed under the following brands:
- GaviLyte C
- E-Z-Em Fortrans
- Prep Lyte
Despite widespread pediatrician recommendation of PEG laxatives, the FDA never approved them for use by children.
According to the FDA, “Neuropsychiatric adverse events (in children using PEG laxatives) may include:
- Obsessive-compulsive behaviors including repetitive chewing and sucking
- Mood swings”
Another Way to Think About Constipation
Chronic constipation is one of the most common signs that a child has gut dysbiosis and/or a dysregulated immune system or possibly even mitochondrial dysfunction, causing gastrointestinal motility problems. Many children struggle to have healthy daily elimination because of the following, which all can contribute to an unhealthy diet and consequently, unhealthy elimination:
- Processed foods
- Refined carbohydrates
- Unhealthy fats
- Synthetic preservatives
- Lack of movement
- Insufficient water consumption
Intermittent constipation can often be managed by taking some relatively easy steps such as:
- Increasing fiber content in diet (fruits, vegetables)
- Supplementing the diet with certain foods such as flax seed, flax oil, or psyllium
- Increasing consumption of water
When constipation becomes chronic and won’t let up, it is critical to begin investigating the underlying causes of constipation. There is no doubt that what we eat as humans affects how well we eliminate. But is there more?
Breaking the vicious cycle of constipation is not just about the right laxative or eating one type of food to make the bowels regular such as that big bowl of stewed prunes every morning. Regularity is more about having healthy choices of food on a regular basis. However, there may be some underlying imbalances that create the constipation symptoms your child is exhibiting. It is also possible that there may be more than one symptom connected to your child’s constipation.
Let’s identify some of these imbalances and learn how to correct them so that we can address these underlying issues that may be triggering the constipation your child is experiencing.
Constipation Checklist to Start
Does your child have a vicious constipation cycle: constipation -> acid reflux -> difficulty falling asleep –> pain –> irritability –> aggression and medications? Or does your child hold his bowel movements out of fear because they hurt (encopresis)? Either way, our checklist of items below can give you some good ideas for addressing your child’s chronic constipation and/or diarrhea.
Make dietary changes:
- Eliminate gluten- and dairy-containing foods, which are commonly known to produce constipation when eaten
- Eat whole foods
- Buy organic foods
- Remove all GMO foods
- Remove all fast and processed foods
- Choose complex carbohydrates such as whole grains and high-fiber cereal over simple carbohydrates. Examples of whole grains are:
- Brown rice
- Remove all foods with:
- Artificial colors
- Artificial ingredients
- With an elimination diet, remove potentially inflammatory foods such as:
- Strictly limit:
- Refined salt
- Refined carbohydrates
- Add in fiber-rich foods:
- Fresh figs
- Gluten-free oats
- Brown rice
- Citrus fruits such as oranges and grapefruits
- Sweet potatoes
- Flaxseed meal
- Pistachios and other nuts
- Whole grains and cereals
- Green peas
- Chia seeds
- Salad greens
- Don’t microwave food – precious enzymes in foods needed for healthy elimination are destroyed
- Keep the skin on fruits and vegetables because the skin contains lots of fiber
- Encourage your kids to eat fruits and not to drink fruit juices
- Discourage dry salty products such as chips and salty snack foods as they can contribute to constipation
- Olives and cold press extra virgin olive oil on vegetables and in your cooking (go Mediterranean)
- Love those leafy greens such as kale, collards, watercress, arugula and dandelion and have your kids drink the vegetable water…a great source of minerals!
- Peppermint tea or peppermint essential oil can help relieve temporary digestive issues
- Fennel tea or fennel essential oil can help relieve gas and bloating
- Make sure your children are taking the time to chew their food well because good digestion starts in the mouth!
- Are your children drinking enough water? Dehydration can lead to dry stuck stools and little pellets. Give your child coconut water or electrolytes, and make sure they are drinking plenty of good filtered water.
Use digestive aids with your practitioner’s guidance:
- Betaine hydrochloric acid
- Digestive enzymes with DPP-IV for gluten and casein intolerances
- Proteolytic enzymes
DPP-IV (dipeptidyl peptidase IV) enzymes might just be what your child needs. A full complete broad-spectrum enzyme including DPP-IV can be the key to breaking the vicious constipation cycle and addressing the peptide known as casomorphin (research of Paul Shaddock). A gluten-free/casein-free diet in combination with DPP-IV enzymes from companies such as Houston Enzymes, Klaire Labs, Kirkman Labs and Enzymedica is often enough to relieve chronic constipation.
Heal the gut with special diets such as:
- GAPS (Gut And Psychology Syndrome) diet
- Paleo diet
- GF/CF (gluten-free/casein-free) diet
- Body Ecology Diet
- Modified Atkins Diet (replaces the Ketogenic diet)
- The Rotation Diet
Learn more about healing diets and foods.
Ask your pediatrician to run some laboratory tests for:
- Possible food sensitivities and allergies. Food intolerances and food sensitivities can be a major source of distress. IgE and IgG food allergy testing may indicate exactly what foods may be causing problems in the gastrointestinal tract that can lead to constipation.
- Enzyme-Linked Immunosorbent Assay (ELISA) IgG, IgA, IgE and IgM
- Nutritional deficiencies in vitamins and minerals. The NutrEval by Genova Diagnostics Labs covers the following areas:
- Cellular energy
- Mitochondrial metabolism
- Neurotransmitter metabolism
- Vitamin deficiencies
- Toxin exposure
- Detoxification need
- Bacterial and yeast overgrowth
- Gluten and casein sensitivities
- Organic acids: The organic acid test by Great Plains Laboratory for:
- Yeast overgrowth (Candida)
- Other microbial infections
- Comprehensive Stool Analysis by Genova Diagnostic Labs to identify:
- Altered gastrointestinal function
- Bacterial/fungal overgrowth
- Chronic dysbiosis
Add fermented foods and probiotics daily:
These will keep the gastrointestinal system and microbiome healthy and strong which in turn will keep the immune system strong.
- Eat kefir yogurts
- Eat fermented vegetables
- Eat umeboshi plums (very alkalizing)
- Eat miso soup, if soy is tolerated
Some good probiotics are:
- Gut Pro
- Dr. Ohirra’s Live Cultured Probiotics
- Garden of Life
- Klaire Labs
Incorporate some cultured or fermented foods in your child’s diet (homemade is the best): coconut keifers, grain keifers, dairy (if your child can tolerate casein) and garnish with seeds and nuts. Other choices of fermented foods maybe sauerkraut, Kombucha tea, cultured or fermented vegetables and pickles. These foods are loaded with beneficial organisms, probiotics and natural enzymes which all help getting those intestines moving!
Healthy intestinal flora creates healthy bacteria in the microbiome. Giving your child daily probiotics can help ensure the proliferation of good bacteria in your child’s gut. Prebiotics such as inulin provide fiber from plant food and populate good bacteria in the small intestines.
Use herbs, essential oils and natural supplements with your practitioner’s guidance:
Healthy nutritionals for the relief of constipation:
- Magnesium is an important mineral that relaxes muscles in the digestion process needed to prevent constipation. Low levels of magnesium can affect normal muscle functioning in the body. Magnesium is an important electrolyte necessary for hydration, it improves gut motility and controls muscle tension to help regulate emotional stress.
- Aloe vera juice can reduce inflammation in the intestinal tract
- Vitamin C can get the bowels moving (Try Vitality C by American Neutraceuticals)
- Homozone colon cleansing
- Colosan by Family Health News or Mag 07 by Aerobic Life – oxygen digestive system cleansers
- Cascara sagrada herbal tincture for gastrointestinal support
- Cod liver oil, a traditional remedy
Investigate mitochondrial dysfunction:
Low muscle tone in the bowel can lead to a weak peristalsis movement to push the stool out. Many children with neurodevelopmental disorders and developmental delays have mitochondrial issues leading to low internal muscle tone.
One way to increase the muscle tone in the bowel area is to give your child liquid trace minerals. Colloidal trace minerals or trace minerals with fulvic acid can be put in juice. They are also very good for the toddler who is unable to toilet train. Sometimes it’s just a matter of increasing the muscle tone in the bowels in both situations.
Check for thyroid disorders:
Thyroid disorders such as congenital hypothyroidism, passed on from a mother to her child, can contribute to constipation.
Encourage your child to be active and not sedentary because activity helps keep the organ systems moving and functioning appropriately. Inactivity promotes constipation!
Make sure your child’s environment and lifestyle is not stressful because emotional stress can play a significant role in contributing to constipation. If your child is on medication, check with your pharmacist to see if constipation is one of the side effects, and then discuss the matter with your child’s pediatrician.
Use a Squatty Potty or stool:
Squatting, or at least bringing the knees higher up when sitting, promotes bowel movement because it straightens the spine and allows gravity to do its work without forcing. Using a Squatty Potty or step stool when sitting on the toilet simulates a squatting position and thus makes bowel movements easier.
Still Looking for Answers?
Sources & References
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Chmielewska, A., et al. Systematic review of randomised controlled trials: probiotics for functional constipation. World J Gastroenterol 2010 Jan 7;16(1):69-75.
Greene. J.G., et al. Delayed gastric emptying and enteric nervous system dysfunction in the rotenone model of Parkinson’s disease. Exp. Neurol. 2009 Jul;218(1):154-61.
Higashikawa, F., et al. Improvement of constipation and liver function by plant-derived lactic acid bacteria: a double-blind, randomized trial. Nutrition 2010 Apr;26(4):367-74.
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Madrid, A.M., et al. Small intestinal bacterial overgrowth in patients with functional gastrointestinal diseases. Rev Med Chil. 2007 Oct;135(10):1245-52.
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Pimintel, M., et al. Irritable Bowel Syndrome: Bacterial Overgrowth–What’s Known and What to Do. Curr Treat Options Gastroenterol. 2007 Aug;10(4):328-37.
Galland, Leo. The Effect of Intestinal Microbes on Systemic Immunity. Excerpted from Power Healing. Random House, 1998.
Kellman, Raphael. The Microbiome Diet: The Scientifically Proven Way to Restore Your Gut Health and Achieve Permanent Weight Loss. Da Capo Lifelong Books, 2015.
Sachs, Jessica Snyder. Good Germs, Bad Germs: Health and Survival in a Bacterial World. Hill and Wang, 2007.