My child can’t be constipated, they poop every day!
Sometimes they aren’t getting it all out each day, which is functional constipation!
This is something I hear from parents all the time.
If your child is experiencing:
- urinary incontinence
- fecal incontinence- difficulty potty training- difficulty knowing when the need to pee or poop- infrequent poops- many small poops in one day- cycles of good weeks with no accidents, then bad weeks with many accidents
…. then it is likely that your child is experiencing constipation. Let’s explore this.
There are a lot of misconceptions around constipation; that the poops must be hard, painful, and infrequent. But that’s not necessarily true! Yes, a child who experiences hard, painful, or fewer than 3 bowel movements per week is considered constipated, however, a child who has daily bowel movements may also be constipated. Children who are not able to get all the poop out each time they have a bowel movement experience what is called functional constipation (aka incomplete bowel emptying). Signs of functional constipation can include:
- Multiple small bowel movements spread out in a day
- Having a bowel movement, then a short time later having another one
- Several days or weeks of small or no poops followed by a few days of massive poops
- Bloating or abdominal distention; sometimes accompanied by discomfort
It’s important to note that both “traditional” constipation (infrequent or hard poops) and “functional” constipation can both cause fecal incontinence and urinary incontinence. When poop is backed up in the rectum (the end of the large intestine/colon) it can put pressure on the bladder and not allow it to fill completely. This can result in sudden urgent needs to urinate, and urinary incontinence (pee accidents!). Constipation is the number ONE cause of bedwetting after the age of 5 years old (when children will start being dry at night). It squishes the bladder (where the pee is stored) and doesn’t allow it to fill all the way. Once the bladder thinks it’s completely full, it will signal to the brain that it’s time to go pee… sometimes a child will hear those signals and wake up and go…sometimes they won’t and it’s not their fault. Blame the poop that’s squishing the bladder.
The poop that sits in the rectum waiting to be pushed out continues to harden as the body removes water. New poop that enters the rectum is soft, and thus can “slide” around the old, hardened poop. Imagine pouring pudding over ice; this is what is happening with encopresis (fecal incontinence). Encopresis is very sticky, very stinky leakage that doesn’t “smell” like normal poop. But we’ll get to encopresis in a later post. Just know that it can still happen even if your child is pooping every day.
Constipation is experienced by a THIRD of children and is one of the main reasons that children see a gastroenterologist. It might be difficult to know what to do or where to start for addressing your child’s constipation or incontinence, so it’s important to consult with a trained professional to achieve the best results and full resolution of symptoms.
Do you need help with resolving your child’s incontinence or constipation? Schedule a free 15 minute phone consultation, or book an appointment HERE.
References 1. Jiang R, Kelly MS, Routh JC. Assessment of pediatric bowel and bladder dysfunction: a critical appraisal of the literature. J Pediatr Urol. 2018 Dec;14(6):494-501. 2. Overview: Constipation in children and young people: Diagnosis and management: Guidance (May 26, 2010) NICE. Available at: https://www.nice.org.uk/guidance/cg99.3. Koppen, I.J. et al. (2015) ‘Management of functional constipation in children: Therapy in practice’, Pediatric Drugs, 17(5), pp. 349–360. doi:10.1007/s40272-015-0142-4.