Constipation & Encopresis: What You Need to Know

Constipation is no fun!

Yes, we’re going to talk about poop for a few minutes.

Pooping habits differ from child to child; what’s normal for one child (bowel movements 1 or 2 times a day) may be different for another child (bowel movements a day or two apart). Parents need to be familiar with each child’s bowel pattern and poop size and consistency in order to recognize changes and potential problems. Childhood constipation is usually temporary. It most commonly occurs when stool moves too slowly through the digestive tract causing it to become hard and dry, thus making pooping difficult and consequently something your child wants to avoid. Constipation should be addressed with care to ensure a healthy outcome for your child and to help with the establishment of good bathroom habits. Chronic constipation can lead to complications or it may be indicative of an underlying issue.

What should we watch for?

A child suffering constipation has infrequent bowel movements or hard, dry stools. Take action if you notice:

    • Fewer than three bowel movements a week
    • Hard, dry bowel movements that are difficult to pass
    • Pain during pooping
    • Stomach pain
    • Soiling accidents such as traces of liquid or pasty stool in the underwear, a sign that stool is backed up in the rectum (it can look like diarrhea)
    • Blood on the surface of hard stool

Children who are afraid to poop or afraid of a painful bowel movement will often practice withholding; you may notice clenched buttocks, crossed legs, body twisting, and different facial expressions – while it may look like they are trying to push out the poop, they are really struggling to hold it in.

What causes it?

Many factors can contribute to constipation.

    • Withholding for various reasons: fear of the toilet, fear of public bathrooms, not wanting to stop play to go to the bathroom, previous experience with painful pooping or having trouble passing a large, hard stool (which can become a vicious cycle – if it hurts to poop, they may be afraid to try again).
    • Potty training problems – if you begin the process too early, it may become a battle of wills and your child could be trying to maintain control by refusing to poop; leaving this too long can lead to chronic constipation.
    • Change in routine – some children experience more stress in the absence of a familiar routine, such as during vacations or when traveling.
    • Diet – not including fiber-rich fruits and vegetables or enough liquid in the diet. It is not uncommon for constipation to occur when switching from an all-liquid diet to solid foods.
    • Allergies to dairy products such as cow’s milk and cheese.
    • A family history of constipation can be indicative of potential problems for children.
    • Medical conditions – rarely, constipation is a symptom of anatomic, metabolic, digestive, or another underlying condition.
    • A sedentary lifestyle – not enough exercise.

What is encopresis?

If your child withholds poop for too long, they may produce such large stools that the rectum stretches. He or she may no longer feel the urge to poop until the stool is too big to be passed without the help of an enema, laxative, or other treatment. Sometimes, only liquid can pass around the stool and leaks out onto your child’s underwear. The liquid stool may look like diarrhea, but it’s not. This problem is called encopresis.

What should we do?

You can take steps to help prevent constipation in your child. Begin offering him or her a fiber-rich diet including fruits, vegetables, beans, and whole-grain cereals. HOWEVER, if this will be a big change to their usual diet, be sure you gradually introduce the high-fiber foods to avoid excess gas and bloating. Encourage your child to drink plenty of water and other healthy drinks, and to be physically active every day. As you are adding fiber to their diet, they will need more fluid to help flush it through their digestive system – and exercise will help, too!

Remember, children learn more from what they see their parents doing than just their words…                                                    learn to model the behavior you’d like to see.

Create a consistent toilet routine, including trips to the bathroom about 20 minutes after meals. Especially with younger children, don’t ask “do you need to go?” Simply say, “it’s time to go to the bathroom now.” A footstool will position them on the toilet to more easily release their poop. Remind them to learn to listen to their bodies and to try to go to the bathroom whenever they feel the urge. Be encouraging and supportive of their bathroom efforts even if they are not successful every time; please do not punish a child who has an accident in between bathroom trips.

The use of a stool softener or laxative may be recommended. Laxatives are commonly needed, even for as long as several months, to establish better bowel tone and habits. A bowel clean-out may be required when first starting laxative use. Parents and physicians together should choose the laxative or combination of laxatives to use; dosage adjustments may be required to achieve a healthy 1 to 2 bowel movements a day. Common mistakes are inadequate dosing and stopping treatment too soon. Carefully measure doses and follow all instructions.

Also, be sure to review all medications with the doctor; if a particular drug is causing constipation, there may be other options.

When should we call the doctor?

Call before trying a laxative or stool softener. If constipation lasts longer than two weeks or is accompanied by additional symptoms such as fever, lack of appetite, swollen tummy, weight loss, pain during pooping, or blood in the stool, go ahead and schedule that appointment with the doctor.

Knowing the signs and a few steps to take will prepare you to help your child overcome constipation.

WobL potty reminder watches

Tools to help you and your child.

WobL & WobL+ Watch

Good bladder habits lead to better bowel movements. The WobL vibrating reminder watch helps kids establish healthy, consistent bathroom habits. It’s a full-featured time-and-date watch with a repeating countdown timer alarm, 8 unique alarms, audible and/or vibration alarm settings, and more. We recommend using the repeating countdown timer during the day for regular reminders to take a bathroom break. Teachers enjoy it when children use a reminder watch – fewer classroom accidents to manage. The WobL watch is a great accessory for adults, too – use the 8 alarms to set appointment or medication reminders or as a wake-up alarm. The world’s smallest vibrating watch, the vibration setting is great for meetings – you’re the only one alerted. Customers have reported success using the WobL’s features with those who have Autism, ADD/ADHD, and the hearing and vision impaired. The WobL comes in four color choices – black, blue, purple or pink with a hook-and-loop-close band.

The WobL+ waterproof vibrating reminder watch offers 9 alarms, is waterproof to 10 ATM, and comes in black, blue, green or pink with a silicone band. (All our watch bands are interchangeable.) 

Get help setting your WobL watch features on YouTube.

Potty Monkey

Potty Monkey can help with constipationFor younger boys and girls who are still learning about toilet training, Potty Monkey and the Potty Monkey Watch are a fun way to engage in establishing healthy and consistent bathroom habits. With the included reward chart and stickers and lots of encouragement, you and your family will have success. The interactive Potty Monkey system includes a plush, talking, singing monkey and flushing-sounds toilet. It’s designed to take the pressure off Mom and Dad by letting Potty Monkey remind your little one in a fun way when it’s time to “go” throughout the day. Set his timer for audible reminders every 30 or 90 minutes. When placed on his toilet, Potty Monkey says and sings encouraging messages.

Add a Potty Monkey countdown timer watch for additional help with the process – set it for reminder messages every 10 to 120 minutes, especially useful when your child is on the move during the day. His flashing green eyes grab attention as he says “It’s time to go potty! Let’s go potty!” He comes with a free reward chart and colorful stickers to reward potty-use progress.

Potty Monkey, your child’s potty training pal, comes with a board book for children and a complete potty training guide for Mom and Dad, written by a board-certified pediatric urologist. Learn about the process and choose the training method that will work best for your family. Be sure to visit the Potty Monkey channel on YouTube!

I wish Potty Monkey had been around when I was training my kids! I’m planning to get him for my grandchildren for sure.    ~Janet L.