Hello everyone!
We’re here to talk about functional constipation!
Constipation occurs when there are fewer, harder bowel movements.
It is common, affecting up to 30% of children and is even more common in children with autism spectrum disorder.
Today we’re going to meet Jessica, a 10 year old who has autism spectrum disorder as well as constipation.
She is here to ask her doctor a few questions. Let’s listen in!
Dr. Roberts: Hi Jessica! It’s good to see you again.
Jessica: Hi Dr. Roberts!
I have been having some hard painful poops and tummy pain and my mom told me that I should talk to you about it.
Dr. Roberts, why do I even make poop?
Dr. Roberts: Good question Jessica!
So when you eat, the food goes through your mouth, to your stomach.
There, it gets broken down and goes to your small intestine, where all the good nutrients are absorbed.
After that, it goes into your large intestine. This is where it becomes what we know as poop.
That’s how the body gets rid of waste.
The large intestine also takes out extra water from poop.
But when the poop stays there too long, it can accidentally take out too much water, making the poop hard and painful to pass.
Jessica: Oh, is that why my poops are hard?
Dr. Roberts: Well constipation can be caused by many things,
but it is usually caused by the foods that you eat or by doing certain things.
What sorts of food do you like to eat Jessica?
Jessica: I like to eat chips, french fries, and chicken nuggets.
Mom says I need to eat more fruits and vegetables, but I hate fruits and vegetables!
They feel funny in my mouth.
Dr. Roberts: Well chips, french fries, and chicken nuggets are tasty foods,
but they do not have very much of a special nutrient called “fibre”.
Fiber helps us have soft poops. There is a lot of fibre in fruits and vegetables.
There is also fibre in beans, nuts, and seeds.
You can also get constipation if you drink a lot of milk, or don’t drink enough water.
Jessica: Hmm… I guess mom had a point about the fruits and vegetables then.
Dr. Roberts: Yes, she did!
Other factors for constipation can include stressful situation, illness, change in routines and your own actions.
Jessica: Wait! I can cause my own constipation because of something I do?
Dr. Roberts: Yes! If you experience pain when pooping because your poop is hard,
you might not want to poop again and might try to hold your poop in,
this can make your poop even harder.
Jessica: Oh okay! I now understand why my poop can sometimes be hard.
But Dr. Roberts, sometimes my poop comes out onto my underwear and is very wet.
How can my poop be hard and soft at the same time it’s confusing?
Dr. Roberts: That can happen sometimes.
If there has been old poop in your large intestine for a while, the new poop that is being formed, can leak around it and come out.
Whoo - hoo!!!
Jessica: Ooooh! So Dr. Roberts, how often do I need to poop to be healthy?
Dr. Roberts: Great question Jessica!
The answer changes as you grow up.
Between 2 months to 3 years, children can poop 1 or 2 times a day.
It’s normal for children older than 3 years, like you, to poop between 3 times a day and 3 times a week.
Jessica: Oh…
So then, how would a doctor know if I am constipated?
Dr. Roberts: Well, the doctor will ask you and your parents some questions.
Pooping two or less times in a week is a sign that you’re constipated.
We also ask if your poops are painful or hard, if they cause the toilet to clog or blood is on your poop.
Remember those poop accidents we talked about?
If they are happening more than once a week, it could also be a symptom of constipation.
Finally, your doctor will want to know if you’re choosing not to go to the bathroom.
Jessica: Wait, how will my doctor know if I am choosing not to go to the bathroom.
CAN THEY READ MY MIND?
Dr. Roberts: Well no! *chuckle*
They can ask your parents if you do specific things.
For example sometimes when children are trying not to poop they might be standing on their tiptoes,
leaning against something with their back arched, trying to keep the poop in.
Other times, children may rock themselves back and forth, cross their legs or even sit with their bum on their heels.
Jessica: Oh I think I’ve done that.
Do you have other ways to know if kids are constipated?
Dr. Roberts: We actually do!
Sometimes in children who might not be able to talk to us,
like in some autistic children, they might tap or hit their tummy or their chest.
They might also be more upset or do things that hurt themselves by accident.
Sometimes they might sigh or moan or groan more than they usually would
and that’s them trying to tell us about their constipation.
Parents can look for things like grinding or gritting teeth.
We also look to see if they are eating and swallowing things that aren’t food like ice, sand or paper.
This is called “PICA”.
Jessica: That sounds painful. I hope their parents can help them!
Dr. Roberts: Yes they can!
We can treat constipation in many ways.
Having a healthy high fiber diet, drinking water, having regular toilet routine and exercise helps.
Sometimes we may use medication to soften your poop to make it easier to come out.
Jessica: Hmmm it’s good that their parents can help. Dr. Roberts, I have another question.
Dr. Roberts: Of course! What is it, Jessica?
Jessica: Well…
a few months ago my brother had tummy pain like I do. But he needed to go to the emergency room and had a belly surgery.
They said it was “appendicitis” I think. Do I need to go to the emergency room?
Dr. Roberts: Awww, I'm so sorry your brother needed to go to the emergency room.
Most of the time, your family doctor can help you with constipation.
However, if your belly pain comes with fever, vomiting, diarrhea or blood in your poop,
or mom and dad are having a difficult time waking you, then you would need to go to the hospital.
Jessica: Oh I don't have any of that!
Thank you so much for talking to me about constipation today Dr. Roberts!
Dr. Roberts: My pleasure Jessica! See you later!