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Tag: Constipation

Do Your Kids Suffer From Travel Bowel?

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Posted by Dr. Monica Wonnacott | September 25, 2017

Many people suffer from bowel upset when they travel (constipation and/or diarrhea). When you travel, you eat different foods at different times. It can throw your GI system into a mess. We recently went on a family vacation. After a long day of travel, my two year-old acted like she needed to go poop. She found a corner to poop in (her M.O. these days) and after turning bright red (obviously straining), she started to scream hysterically. I took a look in her diaper and it was full of blood (no poop). I felt so bad for her. Even though I had anticipated such possible problems (packing some Miralax), I hadn’t given it to my child and ended up doing too little, too late.

How to prevent bowel problems when traveling

Every so often, a kid comes along that never has trouble pooping. If yours is that kid, skip this section. For the vast majority of everyone else, read on. The key to the travel bowel is anticipating and prepping. With a little effort, you’ll be leaps and bounds ahead of me.

  1. Make sure your child drinks plenty of fluid on the days of travel.
  2. Try to keep meal times and types of foods as “typical” as possible, and include lots of naturally rich fiber foods (e.g., fruits and veggies). If fiber-rich foods are hard to come by, you can always try a fiber gummy.
  3. Don’t be afraid to give a small dose of Miralax (maybe half a dose of a previously tried amount) if your child is particularly inclined to constipation.
  4. Don’t let your child go more than his/her usual interval between poops before intervening. For example, if your child stools 1-2 times a day and you get to the end of the day with no poop, give some Miralax. Don’t just wait it out (as a little problem will often compound into a big problem—see my above example).
  5. Be aware of your children’s stooling while on vacation. I know it sounds crazy (I don’t normally ask my 10 year old if he’s pooped every day), but prevention is a lot easier than treatment.

How to treat, once the damage is done

Hopefully, you don’t have to go down this road (as we did), but better to know what to do than have to run to the emergency room because of some bloody poop.

  1. Start with an enema to get things flowing from the bottom. Prep yourself. Giving your child an enema will rank right up there in the “gross things you have to do a as a parent.” I think that the Fleets enema is one of the easiest to use (and in most cases, it is the one most often stocked in stores). In our case, the only market open late at night had a regular (adult) Fleets enema. I just used half of the enema.
    1. To do it: Start on a tile floor (easier to clean up) and move the bathroom mat. Roll your child on his/her side in the fetal position next to the toilet. If the child is young enough to be diapered, lift the legs like you are changing the diaper. Then insert the flexible tip/end into the child’s anus and squeeze out the liquid. If you have someone there to help hold your child, that is ideal. Your child will naturally jump and try to arch away (and it helps to have someone holding the child steady). My child demonstrated super human strength despite my husband holding her and she moved enough to get the tip out two different times! I know, horrifying!
    2. Instruct the child to hold the liquid as long as he/she possibly can (ideally 5 mins). The second he/she can’t hold it any longer, hastily put the child on the toilet. Expect a fair amount of the liquid to come out. Hopefully enough will stay in to loosen the hard stool.
    3. The enema can be repeated another time if needs be. (I’d give it an hour first though.)
  2. Give Miralax to get things moving from the top. Once your child is fully backed up, don’t be afraid to give full doses (you may start with a half capfull in a small child younger than 3 or 4 years-old, and a full capfull in an older child).
  3. Treat anal fissures. If your poor child experiences an anal fissure (as mine did), treat the torn anus with an antibiotic ointment (or Vaseline in a pinch). See article ANAL FISSURES: A COMMON CAUSE OF BLOODY STOOLS.
  4. If your child happens to be suffering from diarrhea, take a look at what your child is eating. Typically diarrhea (that isn’t a food- or water-borne infection) is from a bad diet. Try reducing the juice, soda, and sugary foods/treats and see if that helps slow things down a bit. If you are traveling in a place where clean water is questionable, you may end up having to seek medical care to treat the diarrhea.

May all your travels be uneventful and regular. Happy travels!

Pee Accidents In A Potty-trained Child

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Posted by Dr. Monica Wonnacott | April 11, 2016

If your child, who is fully potty trained, is starting to have daytime pee accidents, you should be concerned. The medical term is diurnal enuresis. It is not developmentally normal and generally indicates a problem. Now if your child has only been trained for a week, I wouldn’t consider that a consistently trained child. A newly trained child may be losing the motivation to stay dry (e.g., no more stickers or toy rewards). I would consider 6 months or longer a consistently trained child. Here are the common causes for kids to suddenly start peeing their pants.

  1. Urinary Tract Infections (UTIs): One of the most common causes of urinary accidents in girls because they have short little urethras (tube that drains the pee out of the bladder) and the pee hole is so close to the poop hole. It is easy for little girls to wipe poop over the pee hole and get infections. UTIs are very uncommon in boys because they have much longer urethras. UTIs usually have other associated symptoms, like painful urination, having to pee frequently, abdominal pain, and/or fever.
  2. Incomplete emptying of the bladder (the medical term is dysfunctional voiding): Sometimes kids get so distracted with activities that when they finally stop and run into the bathroom to go pee, they don’t take the time to fully empty the bladder. The bladder is a muscle, if it isn’t used properly, it can become somewhat dysfunctional.
  3. Diabetes Mellitus (DM): An important cause of urinary accidents in children. Diabetes causes sugars to be elevated. One of the ways the body tries to fix that is to increase thirst (the sugars essentially cause the fluids in the cells to shift). When you drink more, you pee more and sometimes so much so that you can’t control it. Kids with diabetes will often have weight loss, headaches, and/or mood irritability.
  4. Emotional Stress: Major stresses in a kid’s world can cause urinary accidents. Just about any life stressor can do it: parental divorce, death, moving, introduction of a new baby, someone perceived as mean, being bullied, fear, etc. Usually a parent can readily identify the life stressor, but occasionally they don’t know (e.g., if the child is afraid to say something about being bullied). Look for your child to be moody, acting out, withdrawn, clingy, or teary.
  5. Sexual abuse: This is a tricky one. On more than one occasion, I have had urinary accidents be the presenting symptom of a child being sexually abused. It can happen in just about any circumstance by just about anyone.
  6. Constipation: It may not seem like a readily apparent cause of pee accidents, but is actually relatively common. If there is a ton of stool, it may obstruct the outflow of urine or cause pressure on the bladder and trigger a sudden need to pee.

I read once that kids perceived wetting their pants in class as the number 3 most stressful life event (only after death of a parent and going blind). So believe me, your child is worried about wetting his/her pants also. It’s not a problem you should just wait and watch to see if it gets better on its own. Seek medical care.