Constipation and Back to School: Preschool and School-Aged Kids
Big transitions like back to school mean kids are more likely to start the vicious cycle of constipation, especially for kids 3-5 years old - kids hold their poop in because they don’t want to poop, the poop gets dryer and bigger and harder to pass because they’re holding it in, then it’s painful, then they hold it even more because it hurts, and on and on until they can have a very serious problem.
Introduction
95% of constipation functional - meaning that the root cause is usually holding the stool in on purpose at first and starting this cycle that then becomes automatic and out of their control
Kids starting school are most likely to get this
Big life changes like back to school make kids especially likely to withhold
When this goes on for too long, several things happen: that poop ball in the rectum gets bigger and bigger, and if they were scared of pooping before now they’re terrified because whenever they go it’s like passing a big dry potato that is truly excruciating; also, this big poop ball actually stretches out the rectum and all those muscles can work to contract and relax like they’re supposed to, so now the new soft wet poop slips around that big stool ball, and they’re so stretched out they can’t hold it in, and then all of a sudden there’s poop in their underwear of kids who have been potty trained already, they can’t help it, they can’t stop it, and
The good news: if this has gone on less than 8 weeks, it can be very easy to treat!
It’s never too early to call your child’s pediatrician! We know how bad this can get so quickly, so the earlier you get help the better. Also, if there’s a cause besides this cycle, it’s helpful to get that diagnosed sooner.
Early on, usually the best strategy is behavioral (this part is most important) – making sure that immediately after every meal at home (this helps to re-stimulate the gastrocolic reflex that we’re all born with and lose where you feel the urge to poop as soon as you eat), they have a chance to sit on the toilet. Make sure it’s a fun potty experience for them - maybe they get a little quick video they enjoy, maybe they get their favorite book or toy, maybe you read them a story. They’re not going to poop every time, and that’s ok – it’s just a signal for their body to relax and let it out, that they don’t have to withhold anymore. If you have a great relationship with their teacher, maybe they can help your child do this at school too. If they can’t do it at school, that’s okay – if you help them at home at breakfast and dinner, if they can poop 1-2 times per day, that’s awesome.
Good luck this school year, and keep those kids pooping!
