Blog Post 3/3 – Constipation and Encopresis- Behavioral Management –
I discussed in previous posts Common ways constipation can present in childhood and Nutritional and Supplement Solutions for constipation.
This post addresses Behavioral Modifications to treat Constipation and Encopresis
– best time to have kids sit on the toilet is 5-10 min after meals. This is when the gastrocolic reflex or the movement of the intestines is the greatest.
– make sure that for kids sitting on the toilet there is a stool under their feet. Pooping with dangling feet is nearly impossible.
Keeping knees bent may not be enough. Some kids may benefit from the squatting position while on the toilet
– make toilet sitting fun. Majority of kids with constipation or encopresis refuse to sit on the potty because of the Fear of Missing Out (FMO) phenomenon.
How to make toilet sitting fun:
- A basket of books or games can help distract.
- For some kids, using electronics ONLY when sitting on the potty can get them sitting more regularly.
- Of course sticker and reward charts can also help.
- Blowing Bubbles, Blowing into Paper Whistles, or Blowing up balloons, can help distract AND push poop and pee out.
Being Active Daily:
- Daily 60 min of physical activity will help improved digestion and bowel function. It helps increase movement of food through the large intestine. The less time that food spends in the intestine, the less water is absorbed from the food and its remains, thus leading to softer stools.
- Increasing heart rate and oxygen exchange, leads to more efficient muscle contraction in all your organs especially in the intestine. The more efficiently the intestines contract, the easier it is to pass poop.
- Exercise increases blood flow to the stomach and the intestines which increases the secretion of digestive enzymes. This breaks down food more efficiently and leads to softer poops.
Physical Therapy by a therapist trained and specializing in pelvic floor dysfunction can be a beneficial addition to the treatment of constipation. When the pelvic floor muscles are weak or do not contract properly, it can lead to constipation, straining with bowel movements, feeling of incomplete evacuation. A specialized PT will conduct and evaluation and discuss a treatment plan customized to you or your child.