Constipation is the act of finding difficult in defecation. There may be pain while defecation and may long last for at least 2-4 days. This condition commonly noticed in infants below 8 months old. This is mainly due to the lack of fiber in the diet of the infant (mostly milk). This condition can be corrected by manipulating the dietary pattern in the infants.

Treatment may be directed at a specific cause. For example, the doctor may recommend discontinuing medication or performing surgery to correct an anorectal problem such as rectal prolapse. Infant with chronic constipation caused by anorectal dysfunction can use biofeedback to retrain the muscles that control release of bowel movements. Biofeedback involves using a sensor to monitor muscle activity that at the same time can be displayed on a computer screen, allowing for an accurate assessment of body functions. Surgical removal of the colon may be an option for the infant with severe symptoms caused by colonic inertia. However, the benefits of this surgery must be weighed against possible complications, which include abdominal pain and diarrhea.

Sometimes constipation can lead to complications. These complications include hemorrhoids caused by straining to have a bowel movement or anal fissures (tears in the skin around the anus) caused when hard stool stretches the sphincter muscle. As a result, rectal bleeding may occur, appearing as bright red streaks on the surface of the stool. Treatment for hemorrhoids may include warm tub baths, ice packs, and application of a special cream to the affected area. Treatment for anal fissure may include stretching the sphincter muscle or surgical removal of tissue or skin in the affected area. Sometimes straining causes a small amount of intestinal lining to push out from the anal opening. This condition, known as rectal prolapse, may lead to secretion of mucus from the anus.

Usually eliminating the cause of the prolapse, such as straining or coughing, is the only treatment necessary. Severe or chronic prolapse requires surgery to strengthen and tighten the anal sphincter muscle or to repair the prolapsed lining. Constipation may also cause hard stool to pack the intestine and rectum so tightly that the normal pushing action of the colon is not enough to expel the stool. This condition, called fecal impaction, occurs most often in children and older adults. An impaction can be softened with mineral oil taken by mouth and by an enema. After softening the impaction, the doctor may break up and remove part of the hardened stool by inserting one or two fingers into the anus.

Diet treatments for infants

Give 2-4 oz of water or diluted fruit juices (such as apple or prune) 1-2 times each day, or try switching to a soy formula. If your infant is over four months old and has constipation, you may also try feeding foods with a lot of fiber, such as cereals, strained prunes, apricots, or spinach. If your infant has severe or difficult to treat constipation, especially if he also has other symptoms, like weakness and poor muscle tone, ask your doctor about botulism.

Stool softeners

Most of these medicines for constipation are available in the pharmacy over the counter and do not require a prescription. They include Metamucil, Milk of magnesia, Citrucel, or mineral oil. Unlike laxatives in adults, they are generally not considered to be habit forming. You should use them once or twice a day and work up on the dose until your child is having a soft BM each day. If you child starts to have diarrhea, then you are giving too much and you should cut back on the dose. Senokot is also often commonly used in children, but it is actually a stimulant laxative and not a stool softener, so you may not want to use it for long periods of time. A newer medicine, Miralax, is available only by prescription to treat constipation, but is very effective.

Once your child is having 1-2 soft stools each day you should continue with the doses of the medicines that you are using for 6-12 months until he is accustomed to his new non-constipating diet. You can then gradually stop the stool softeners by slowly lowering the amount you are giving every 1-2 weeks. If stools are too loose then cut back on the dose by one-third. If stools are still too hard then increase the dose by one-third. Avoid making changes in the medicines based on one bowel movement, or you will wind up ‘seesawing' with the doses.

 

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