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Children & Bowel Habits

Introduction

Bowel movements are important to remove waste from the bowel as stool or motion which is a normal physiological process in the body. Bowel movements vary from child to child as regards, how much and how many times they pass stool. Based on age normal bowel movement in a child may vary between 1-2 times a day to once in every 2-3 days.

Normal bowel movements is attributed to passing stool without discomfort or pain with a frequency that is usual / normal for the child. Ideally children should have bowel movement and pass stool smoothly once in a day. Changes in bowel movements such as frequent bowel movements more than usual (diarrhoea) or less bowel movements than usual (constipation) may occur due to various reasons in children.

Healthy lifestyle and diet lead to good bowel habits that facilitate healthy regular bowel movements, which keep the children happy and healthy.

What Are the Abnormalities Seen in Bowel Movements of Children?

Some children suffer from abnormal bowel movements due to many reasons. Common bowel disturbances seen in children are –

  • Frequent bowel movements more than the usual number of bowel movements and may be 3-4 times a day. Increase in bowel movements with change in stool consistency is known as diarrhoea.
  • Not passing stool and has less bowel movements than usual or has less than 4 bowel movements in a week is usually termed as constipation.
  • A child may have diarrhoea for sometime and constipation for sometime, which may be similar to an Irritable bowel syndrome.
  • Abdominal discomfort or pain associated with altered bowel movements with / without fever may occur due to infections.
  • Change in the colour of the stool to red, black, green yellow or white and greasy is abnormal as it denotes gut/bowel disease.

5 Common Symptoms of Bowel Disorder

  1. Frequent bowel movements, more than usual
  2. Decreased bowel movements, lesser than usual
  3. Abdominal discomfort or pain with or without fever
  4. Nausea or vomiting
  5. Bloating sensation or Gas in abdomen

What Symptoms Are Associated with Constipation?

The most common bowel disorder in children is constipation. The term constipation is used when the child has the following symptoms:

  • Passes stool less often than usual or the daily routine ( usually if less than 4 times a week)
  • Hard and dry stool or faeces which is difficult to pass.
  • Has distension / bloating discomfort or pain in the abdomen.
  • Strains to go to toilet and is scared to pass stool as it causes pain.
  • Has tear or fissure in the anus due to injury caused by passing hard stools.

Causes of Constipation

  • A low fibre diet that has no fruits or vegetables
  • Too much milk or milk products or juices which make the child feel full and avoid other foods.
  • Lack of physical activity or exercise which can slow the bowel movements.
  • Medications which can slow the bowel movements.
  • Afraid of using toilet when bowel movement occurs due to pain while passing stool.
  • Emotional stress which can affect the bowel movements.

What Are Symptoms of Diarrhoea in Children?

A child who has frequent bowel movements with following symptoms –

  • Increase in the frequency of bowel movements more than usual in a day, with stool being softer and loose or of watery consistency.
  • Sometimes stool may have blood or mucous with it.
  • Passing of stool may be associated with abdominal cramps.
  • May be associated with bloating and gas in the abdomen
  • When there is bowel infection, the child can have fever with chills.
  • Children who have chronic diarrhoea or frequent bowel movements for a longer time can have weight loss and nutrient deficiencies.

What Are the Causes of Diarrhoea?

Diarrhoea means frequent bowel movements more than the normal bowel movements and is caused by many reasons such as –

  • The most common cause of diarrhoea in children is infection which is caused by bacteria and virus, but usually due to virus. Rotavirus is the commonest organism which causes diarrhoea in children.
  • Indigestion can cause frequent bowel movements in children as, partly digested food may cause inflammation.
  • Parasite infections by worms and protozoa can cause inflammation of the bowel which may cause diarrhoea.
  • Children who have lactose intolerance, that is inability to digest lactose, the sugar present in the milk can lead to frequent bowel movements.
  • Sometimes diarrhoea can be a side effect of medications like antibiotics etc.
  • Psychological causes like anxiety, depression, family issues, or any abuse may also cause changes in bowel movements and habits in children.

10 Natural Ways to Encourage the Child to Develop Healthy Bowel Habits?

  1. Eating healthy diet which contains good amount of fibre like vegetables (lentils, beans, chickpeas, leafy vegetables), fruits (berries, apples with skin, oranges and pears), whole grains (oatmeal) and such.
  2. Drinking enough water daily and taking other fluids like fresh fruit juices.
  3. Keeping active throughout the day or doing good exercise which can help move the bowel well.
  4. Teaching child about bowel movements, personal hygiene and toilet training, so that the children develop daily routine of passing stool and not holding the bowel back.
  5. Parents to be supportive to children and make the child feel that passing stool is a natural process and not a dirty thing.
  6. Review any medications which may cause changes in bowel habits.
  7. Include natural laxatives daily for constipation such as apricots, prunes, plums, peaches and pears which help improve bowel movements.
  8. Avoid excessive caffeine containing foods or beverages like chocolates, soft drinks and energy drinks.
  9. Reduce stressful activities and treat psychological issues with proper counselling.
  10. Use of probiotics like yogurt in diet or as supplements to improve bowel health whenever required.

What Are Probiotics and How Do They Help the Bowel in Children?

  • Probiotics are good microorganisms that are useful to improve the bowel flora and grow good bacteria, which keeps the bowel healthy.
  • Probiotics are used for diarrhoea as they can help slow the bowel movements daily or for constipation as they can increase the bowel movements weekly and soften the stool making it easier to pass.
  • Probiotics are used in children who are prescribed antibiotics as the antibiotics may also destroy the good bacteria.
  • Probiotics may help prevent secondary infections in children.

Which Probiotics Are Helpful for Healthy Bowel Movements?

There are some probiotics which can relieve bloating and help bowel movements such as –

  1. Lactobacillus rhamnosus
  2. Lactobacillus paracasei
  3. Lactobacillus acidophilus
  4. Lactobacillus sporogenes
  5. Bifidobacterium longum
  6. Saccharomyces boulardii

Foods Which Contain Probiotics

  • Yogurt is rich in probiotics.
  • Cottage cheese
  • Buttermilk
  • Sauerkraut

Conclusion

Children with regular bowel movements without discomfort or pain are happy and healthy. Most common bowel problems in children are frequent bowel movements or diarrhoea, and less bowel movements or constipation.
Usually unhealthy lifestyle and lack of toilet training cause constipation in children, which makes the child dull, irritable and emotional.

Probiotics like yogurt is very useful and can be added to diet to help the child develop normal bowel movement. Probiotic supplements to be used with doctors consultation. Encouraging healthy bowel habits is the best way to help children develop regular bowel movements and keep their bowel healthy.

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