What are the common types of bowel disorders. What symptoms do they cause. How are bowel disorders diagnosed and treated. What lifestyle changes can help manage bowel problems. How do bowel disorders impact overall health and quality of life.

Understanding Bowel Disorders: An Overview

Bowel disorders encompass a range of conditions affecting the digestive system, particularly the small and large intestines. These disorders can significantly impact nutrient absorption and cause various uncomfortable symptoms. Understanding the different types of bowel disorders, their symptoms, and available treatments is crucial for effective management and improved quality of life.

Common Types of Bowel Disorders

Several bowel disorders can affect adults, each with its unique characteristics and challenges. Here are some of the most prevalent types:

Irritable Bowel Syndrome (IBS)

IBS is one of the most common bowel disorders, affecting approximately 12% of the U.S. population. It is characterized by abdominal pain, changes in bowel habits, and alternating episodes of diarrhea and constipation. The exact cause of IBS remains unclear, but factors such as gut sensitivity, muscle contractions in the intestine, severe infection, and stress may play a role.

Inflammatory Bowel Disease (IBD)

IBD is an umbrella term for conditions causing inflammation in the digestive tract. The two main types of IBD are:

• Crohn’s Disease: Can affect any part of the digestive tract, but primarily involves the small intestine.
• Ulcerative Colitis: Affects the large intestine (colon) and rectum.

IBD can lead to severe abdominal pain, diarrhea, and malnutrition if left untreated.

Celiac Disease

Celiac disease is an autoimmune disorder triggered by gluten consumption. It causes damage to the small intestine, leading to various digestive and non-digestive symptoms. Adhering to a strict gluten-free diet is the primary treatment for celiac disease.

Diverticulosis and Diverticulitis

Diverticulosis occurs when small pouches (diverticula) form in the colon wall. While often asymptomatic, it can lead to diverticulitis if these pouches become infected or inflamed, causing abdominal pain, fever, and changes in bowel habits.

Recognizing the Symptoms of Bowel Disorders

Bowel disorders can manifest through various symptoms, some of which may overlap across different conditions. Common signs include:

• Abdominal pain and cramping
• Changes in bowel habits (diarrhea or constipation)
• Bloating and excessive gas
• Blood in stools
• Unexplained weight loss
• Fatigue
• Nausea and vomiting

Can bowel disorders cause symptoms beyond the digestive system? Yes, some bowel disorders can lead to extraintestinal symptoms such as joint pain, skin rashes, and eye inflammation, particularly in conditions like IBD.

Diagnosing Bowel Disorders: What to Expect

Diagnosing bowel disorders often involves a combination of methods:

1. Medical history and physical examination
2. Blood tests to check for inflammation markers and nutrient deficiencies
3. Stool tests to detect infections or blood
4. Imaging studies such as CT scans or MRIs
5. Endoscopic procedures like colonoscopy or upper endoscopy
6. Biopsy of intestinal tissue for microscopic examination

How long does it typically take to diagnose a bowel disorder? The diagnostic process can vary widely depending on the specific condition and individual circumstances. Some disorders may be diagnosed quickly, while others might require extensive testing over several weeks or months.

Treatment Options for Bowel Disorders

Treatment approaches for bowel disorders vary based on the specific condition, severity, and individual patient factors. Common treatment options include:

Dietary Modifications

Many bowel disorders respond well to dietary changes. For example:

• Low FODMAP diet for IBS
• Gluten-free diet for celiac disease
• High-fiber diet for diverticulosis

Medications

Various medications can help manage symptoms and underlying inflammation:

• Anti-inflammatory drugs (e.g., mesalamine, corticosteroids)
• Immunosuppressants
• Antidiarrheal agents
• Antibiotics for infections
• Probiotics to support gut health

Lifestyle Changes

Adopting healthier lifestyle habits can significantly improve bowel health:

• Regular exercise
• Stress management techniques
• Adequate hydration
• Smoking cessation

Surgical Interventions

In severe cases or when complications arise, surgery may be necessary. This is more common in conditions like IBD or severe diverticulitis.

Are there any new or emerging treatments for bowel disorders? Yes, research is ongoing, and new therapies are continually being developed. For instance, fecal microbiota transplantation (FMT) shows promise for certain conditions, and targeted biologic therapies are expanding treatment options for IBD.

Living with Bowel Disorders: Coping Strategies and Support

Managing a chronic bowel disorder can be challenging, but various strategies can help improve quality of life:

• Join support groups to connect with others facing similar challenges
• Work with a dietitian to develop a personalized nutrition plan
• Practice stress-reduction techniques like meditation or yoga
• Maintain open communication with healthcare providers
• Plan ahead for travel and social situations
• Educate family and friends about the condition

How can individuals with bowel disorders maintain a social life? With proper planning and communication, it’s possible to maintain an active social life. This may involve identifying safe food options at restaurants, knowing the location of restrooms, and being open with friends about limitations or needs.

Preventing Bowel Disorders: Risk Factors and Lifestyle Choices

While not all bowel disorders can be prevented, certain lifestyle choices may reduce the risk or severity of some conditions:

• Maintain a balanced, high-fiber diet
• Stay hydrated
• Exercise regularly
• Manage stress effectively
• Avoid smoking and excessive alcohol consumption
• Practice good hygiene to prevent infections

Can probiotics help prevent bowel disorders? While research is ongoing, some studies suggest that probiotics may help maintain gut health and potentially reduce the risk of certain bowel disorders. However, more research is needed to establish definitive preventive benefits.

The Impact of Bowel Disorders on Overall Health

Bowel disorders can have far-reaching effects on overall health and well-being:

Nutritional Deficiencies

Many bowel disorders interfere with nutrient absorption, potentially leading to deficiencies in vitamins, minerals, and other essential nutrients. This can result in complications such as anemia, osteoporosis, and weakened immune function.

Mental Health

Living with a chronic bowel disorder can take a toll on mental health. Many individuals experience increased rates of anxiety and depression. The gut-brain connection is an area of ongoing research, with emerging evidence suggesting a bidirectional relationship between gut health and mental well-being.

Quality of Life

Bowel disorders can significantly impact daily life, affecting work productivity, social relationships, and overall life satisfaction. Managing symptoms and adhering to treatment regimens can be time-consuming and emotionally draining.

Increased Risk of Other Health Conditions

Some bowel disorders are associated with an increased risk of other health problems. For example, individuals with IBD may have a higher risk of colorectal cancer, while those with celiac disease may be more prone to other autoimmune disorders.

How can individuals with bowel disorders optimize their overall health? A holistic approach is key, focusing not only on managing digestive symptoms but also on maintaining good general health through regular check-ups, appropriate screenings, balanced nutrition, and attention to mental health needs.

Advances in Bowel Disorder Research: What’s on the Horizon?

The field of gastroenterology is rapidly evolving, with promising developments in the understanding and treatment of bowel disorders:

Microbiome Research

Scientists are delving deeper into the role of the gut microbiome in bowel health. This research may lead to new therapeutic approaches targeting the microbial balance in the intestines.

Precision Medicine

Advances in genetic and molecular profiling are paving the way for more personalized treatment approaches, allowing doctors to tailor therapies based on an individual’s unique genetic makeup and disease characteristics.

Novel Drug Therapies

New classes of medications are being developed, including targeted small molecules and biologic therapies that offer more precise mechanisms of action with potentially fewer side effects.

Stem Cell Therapies

Research into stem cell treatments for conditions like IBD shows promise for repairing damaged intestinal tissue and modulating the immune response.

Artificial Intelligence in Diagnostics

AI-powered tools are being developed to assist in the diagnosis and monitoring of bowel disorders, potentially improving accuracy and efficiency in patient care.

What potential breakthroughs in bowel disorder treatment are researchers most excited about? While many areas show promise, the development of gut-specific immunotherapies and the potential for microbiome-based treatments are generating significant excitement in the research community.

Navigating Healthcare: Tips for Patients with Bowel Disorders

Effectively managing a bowel disorder often requires navigating a complex healthcare system. Here are some tips for patients:

• Build a strong relationship with a gastroenterologist who specializes in your specific condition
• Keep detailed records of symptoms, treatments, and their effects
• Don’t hesitate to seek second opinions for complex cases or treatment decisions
• Learn about your insurance coverage and available financial assistance programs
• Explore complementary therapies under medical supervision
• Stay informed about the latest research and treatment options

How can patients effectively communicate with their healthcare providers? Preparation is key. Before appointments, write down questions, concerns, and any changes in symptoms. Be honest about adherence to treatment plans and any alternative therapies being used. Clear communication can lead to better outcomes and more personalized care.

The Role of Diet in Managing Bowel Disorders

Diet plays a crucial role in managing many bowel disorders. While dietary needs can vary significantly between individuals and conditions, some general principles often apply:

Identifying Trigger Foods

Keeping a food diary can help identify specific foods that exacerbate symptoms. Common triggers include dairy products, caffeine, alcohol, and high-fat foods.

Increasing Fiber Intake

For many bowel disorders, a high-fiber diet can help regulate bowel movements and promote overall gut health. However, the type and amount of fiber should be adjusted based on individual tolerance and specific condition.

Hydration

Adequate fluid intake is crucial for maintaining proper bowel function and preventing complications like constipation.

Specialized Diets

Depending on the specific disorder, specialized diets may be recommended:

• Low FODMAP diet for IBS
• Specific Carbohydrate Diet (SCD) for IBD
• Gluten-free diet for celiac disease

Nutritional Supplements

In cases where nutrient absorption is compromised, supplements may be necessary to prevent deficiencies.

Can dietary changes alone manage bowel disorders? While diet is a crucial component of managing many bowel disorders, it’s often most effective when combined with other treatments as part of a comprehensive management plan. The effectiveness of dietary interventions can vary greatly between individuals and conditions.

The Psychological Impact of Bowel Disorders

Living with a chronic bowel disorder can have significant psychological effects. Understanding and addressing these impacts is crucial for comprehensive care:

Anxiety and Depression

The unpredictable nature of many bowel disorders can lead to anxiety about symptoms flaring up in social situations. Chronic symptoms and lifestyle adjustments can also contribute to depression.

Body Image Issues

Some bowel disorders, particularly those requiring ostomy bags or causing significant weight changes, can affect body image and self-esteem.

Social Isolation

Fear of symptoms or embarrassment may lead some individuals to avoid social situations, potentially leading to isolation.

Stress Management

Stress can exacerbate symptoms of many bowel disorders, creating a challenging cycle. Learning effective stress management techniques is often an essential part of treatment.

Coping Strategies

Developing healthy coping mechanisms is crucial. This may include:

• Cognitive-behavioral therapy
• Mindfulness and relaxation techniques
• Joining support groups
• Engaging in regular physical activity

How can healthcare providers better address the psychological aspects of bowel disorders? Integrating mental health screenings into routine care and providing access to psychological support services can help address the emotional impact of these conditions. A multidisciplinary approach that includes gastroenterologists, psychologists, and nutritionists can provide more comprehensive care.

Bowel Disorders in Special Populations

While bowel disorders can affect anyone, certain populations may face unique challenges or considerations:

Pediatric Patients

Bowel disorders in children can affect growth and development. Treatment approaches may need to be adjusted to account for nutritional needs and medication effects on growing bodies.

Elderly Patients

Older adults may be more susceptible to certain bowel disorders and may face challenges with medication interactions and comorbidities.

Pregnant Women

Pregnancy can affect existing bowel disorders and may limit treatment options. Close monitoring and specialized care are often necessary.

Individuals with Disabilities

Those with physical or cognitive disabilities may face additional challenges in managing bowel disorders, requiring adapted care strategies and support systems.

Cultural Considerations

Cultural beliefs and practices can influence how individuals perceive and manage bowel disorders. Healthcare providers should be sensitive to these factors when developing treatment plans.

How can healthcare systems better accommodate the needs of diverse populations with bowel disorders? Developing culturally competent care guidelines, ensuring accessibility of healthcare facilities and information, and providing targeted education and support programs can help address the unique needs of diverse patient populations.

symptoms, types, causes & treatment

Bowel disorders include inflammatory bowel disease (IBD), irritable bowel syndrome, diverticulitis, celiac disease, and others. They can affect the digestion of nutrients from food and cause symptoms such as diarrhea and constipation.

Bowel disorders affect the organs in the digestive system, including the small and large intestines.

Untreated, bowel disorders can contribute to other health complications, including:

• joint inflammation or swelling
• malnutrition, meaning a lack of vitamins and nutrients
• anemia, which is when there is not enough oxygen in the blood
• anxiety and depression

This article will look at some of the different types of bowel disorders, their symptoms, and how to treat them.

Bowel disorders affect the organs in the lower gastrointestinal (GI) tract, such as the small and large intestines.

The intestines digest food and absorb vital nutrients into the bloodstream. This means that bowel conditions can cause many symptoms that affect digestion.

Some common signs and symptoms of bowel disorders include:

• excess gas
• bloating
• abdominal pain and cramps
• diarrhea
• constipation
• incontinence

One of the most common bowel disorders is irritable bowel syndrome (IBS).

An estimated 12 % of people in the United States are living with the condition.

The signs and symptoms include:

• abdominal pain or discomfort that comes and goes
• diarrhea
• constipation
• changes in bowel habits

Symptoms arise from sensitivity in the gut and changes in how the gut muscles move as they digest food.

It is difficult for doctors to work out why this happens because there are many different factors that can lead to IBS, including food sensitivity, environmental changes, and stress. Identifying what is behind a person’s symptoms is crucial to developing an effective treatment plan.

IBS is usually a lifelong condition. There is no cure. However, lots of people manage it by changing their diet.

Other common types of bowel disorders include:

Inflammatory bowel disease

Inflammatory bowel disease (IBD) describes several conditions that can cause inflammation in the digestive system.

This swelling causes severe abdominal pain, cramps, and diarrhea. It also affects how the body absorbs nutrients. Untreated, IBD can lead to complications, such as malnutrition and anemia.

The two main types of IBD are Crohn’s disease and ulcerative colitis. Crohn’s disease can affect any part of the digestive tract. However, it usually involves the small intestine. Ulcerative colitis affects the large intestine and rectum.

IBD is a life-long condition. There is no cure. However, people tend to manage it using medication and diet.

Celiac disease

Celiac disease is an autoimmune condition, meaning it a fault in the immune system causes it. It affects the small intestine.

Normally, the immune system goes into action when it detects a foreign body such as a virus or bacteria. In celiac disease, the immune system recognizes the protein gluten as a threat.

Celiac disease can cause a variety of symptoms. Children with the condition may experience:

• abdominal pain or bloating
• diarrhea
• constipation
• vomiting
• anemia
• fatigue, or extreme tiredness

Adults may experience:

• abdominal pain or bloating
• diarrhea
• anemia
• fatigue
• pain the bone or joints
• arthritis
• fragile bones or bone loss
• depression
• anxiety

Over time, celiac disease may also affect organs in the reproductive and nervous systems.

Celiac disease is a life-long condition. People can avoid the symptoms by following a gluten-free diet.

Diverticulosis

Diverticulosis occurs when a weak area in the colon gives way to pressure, creating a little sac or pouch.

Most people with diverticulosis do not experience symptoms. Some may notice blood in their stools if one of the sacs becomes inflamed and swollen. If one bursts, it can cause severe pain and may lead to sepsis. Sepsis is a serious condition that happens when an infection spreads to the blood.

Sometimes, people with diverticulosis develop an infection or inflammation in one or more sacs, resulting in a condition called diverticulitis. This can cause:

• abdominal pain
• constipation
• diarrhea
• bloating
• fever

Doctors may recommend following a high fiber diet. They will typically manage diverticulitis with antibiotics. In severe cases, they may recommend surgery.

The exact cause of a bowel disorder depends on the condition itself.

Factors that can contribute to the development of bowel disorders include:

• genetics and family history
• changes in the gut microbiome, which refers to the delicate balance of bacteria and other microorganisms in the gut
• lifestyle factors, such as smoking, diet, and exercise levels
• certain medications, such as nonsteroidal anti-inflammatory drugs

Some people experience digestive symptoms without having a specific bowel disorder. Common causes include:

Hernia

A hernia develops when there is a weakness in the abdominal wall. Sections of the intestines and abdominal fat can push through this weak spot.

Hernias tends to occur when people strain, maybe to pass a stool or to lift something heavy. Loops of intestine can sometimes become stuck, which can be very painful.

Surgery

Surgery on the lower GI tract can lead to scar tissue. This can cause an intestinal obstruction, or blockage.

People recovering from surgery may experience constipation. Medications or a lack of physical exercise can contribute to the problem.

Surgery takes a significant toll on the body, and people may risk reopening an incision if they strain to pass a stool. Tips on managing constipation after surgery include:

• getting light exercise, if possible
• staying hydrated
• eating high-fiber foods
• avoiding processed foods and dairy products, which can cause constipation

Laxatives can help with constipation. However, not all laxatives are suitable for people recovering from surgery. A person should speak with a doctor before taking laxative medications.

Healthcare professionals use a combination of physical exams and laboratory tests to diagnose bowel disorders.

People who experience symptoms of a bowel disorder on a regular basis should make an appointment with a doctor.

At the appointment, the doctor will ask what symptoms the person has been experiencing and for how long.

Sometimes, doctors may use the Rome IV criteria to diagnose or rule out disorders such as IBS.

Specialized tests and scans may help in the diagnosis of IBD and intestinal obstructions. These can include:

• blood and stool tests
• CT scans
• MRI scans
• upper endoscopy, to examine the inside of the upper digestive tract
• colonoscopy, to examine the inside of the colon

Treatment options vary depending on which bowel disorder a person has.

A healthcare professional may recommend making habit and dietary changes as well as medication and other medical treatments.

Doctors will advise people with celiac disease to avoid gluten.

Sometimes, people with bowel disorders may need surgery.

Habit and dietary changes

Depending on their condition, a person may be able to manage their symptoms by making the following changes to their diet and daily habits:

• avoiding gluten
• avoiding foods that are difficult to digest, including meat, dairy, and beans
• exercising regularly
• reducing stress

Medication

A healthcare professional may also prescribe medication to help treat IBS and IBD. They may also suggest medications to treat the specific symptoms of these conditions, such as diarrhea and constipation.

Some examples of medications that a doctor may prescribe to help treat bowel disorders include:

• immunosuppressants
• corticosteroids
• antibiotics
• biologics
• antidiarrheal medication
• stool softeners or laxatives

Bowel disorders can stop the gut from working properly. That means it cannot absorb all the nutrients it needs from food, leading to malnutrition. This can affect the whole body.

In addition, people with celiac disease may experience problems with their bones, joints, or reproductive system. People with IBD may experience problems with their skin, eyes, liver, joints, or bladder.

Some bowel disorders, such as IBS, IBD, and celiac disease are more common in females than in males, according to a 2020 review.

A person may receive a bowel disorder diagnosis at any time, including during childhood and adolescence.

Bowel disorders can cause many symptoms, depending on which type a person has. In general, they can cause gas, bloating, constipation, and diarrhea.

Some people may be able to control their symptoms by taking certain medications and making lifestyle changes.

People assigned female at birth are more likely than people assigned male at birth to develop disorders such as celiac disease, IBD, and IBS.

A person can speak with their doctor if they suspect that they have a bowel disorder, or if they want to learn more about the long-term outlook and treatment options for their specific diagnosis.

Conditions, Symptoms, Causes, and More

The term “bowel disorders” encompasses a variety of conditions that affect the digestive tract. While irritable bowel syndrome (IBS) is the most common functional bowel disorder, other diagnoses can also fall under this category.

Bowel disorders are conditions that affect your gastrointestinal system and lead to digestive discomfort. Some impact your small intestine, while others impact your large intestine.

There are different categories of bowel disorders, including:

• functional bowel disorders, such as irritable bowel syndrome (IBS)
• inflammatory bowel disorders, such as Crohn’s disease and ulcerative colitis
• malignant bowel disorders, such as colon cancer
• obstructive bowel disorders, such as intestinal obstruction or bowel obstruction

Here, you’ll learn more about functional bowel disorders.

IBS is the most common type of functional bowel disorder. It affects up to 15% of people in the United States, according to the American College of Gastroenterology.

IBS can cause frequent gastrointestinal problems like stomach pain, diarrhea, or constipation. The impact these symptoms can have varies from person to person, ranging from mild to so severe they may interfere with your everyday life.

Functional dyspepsia is a less common type of functional bowel disorder. It involves recurring symptoms of indigestion or upset stomach. This diagnosis is given after ruling out other potential causes, such as gastrointestinal esophageal reflux disease (GERD) or peptic ulcer disease.

Unspecified functional bowel disorder is another less common type of bowel disorder. It’s diagnosed when you have bowel symptoms that don’t fall under another type of digestive diagnosis.

Symptoms can vary from one disorder and person to another. But some symptoms are relatively common across all types of functional bowel disorders. For example, you might experience:

• abdominal pain
• bloating
• gas
• nausea
• diarrhea
• constipation
• vomiting

For most people, these symptoms come and go.

If you experience any bowel disorder symptoms, make an appointment with your doctor. They can help diagnose the cause of your symptoms and recommend a treatment plan.

It’s not fully understood what causes functional bowel disorders. It’s thought that these conditions occur as a result of issues with how the bowels work to digest and absorb food. This leads to uncomfortable digestive symptoms.

With IBS, recent research has established a link between certain chemicals in the gut that send signals to the brain. However, more studies are needed to fully understand this link and how it may impact treatment.

Certain factors can increase your risk of developing a functional bowel disorder, including:

• having a family history
• being female
• being under the age of 50
• smoking
• drinking alcohol
• dealing with chronic stress
• taking nonsteroidal anti-inflammatory drugs (NSAIDs)

To diagnose or rule out IBS, your doctor may assess your symptoms using a set of criteria known as the Rome criteria. They may diagnose IBS if you’ve been experiencing abdominal pain with at least two of the following symptoms:

• changes in the frequency of your bowel movements
• changes in the consistency of your stool
• symptoms that improve after bowel movements

Your doctor may order additional testing to rule out other conditions that might be causing your symptoms. That may include:

• bloodwork
• breath test
• colonoscopy
• endoscopy (with optional biopsy)
• imaging tests
• lactose intolerance tests
• stool tests

If you’re diagnosed with a functional bowel disorder, in many cases, you can control symptoms and lower your risk of complications by following your doctor’s recommended treatment plan. If your symptoms don’t improve or they get worse over time, contact your doctor. Together, you can work to adjust your treatment and management plan.

Constipation – diagnosis and treatment at the medical center “Andreev Hospitals”

Constipation is a complicated, delayed or regular insufficiency of bowel movements.

Constipation is diagnosed when the bowels have not been emptied for 50 hours or more. Constipation is most common in young children and the elderly. It is not considered a disease if the stool becomes regular after the end of the stimulus. If problems with the stool are commonplace, then it is considered chronic.

Causes of constipation

The main reason is the wrong lifestyle:

• Night shifts and irregular hours.
• Nervous exhaustion.
• Long sleep phase, late rise.
• Reduction in plant fiber intake.
• Eating refined foods.
• Uncontrolled consumption of protein and fatty foods of animal origin.
• Fast food food.
• Low water intake.
• Frequent consumption of coffee and strong tea.
• Inactive lifestyle, “sedentary” work.
• Possible drug reaction.

The second is the formation of a tumor in the intestine.

Symptoms of constipation

Experts note the following symptoms of constipation:

• Infrequent bowel movements, less than 4 times a week.
• Small amount of stool during stool.
• You have to push during a bowel movement.
• Dry and hard feces.
• After a bowel movement, there is no feeling of emptying of the bowels.
• Flatulence.
• Appetite reduction.
• Headaches and emotional depression.
• Skin discoloration.

Diagnosis of constipation

If signs of constipation appear, you should immediately consult a doctor. The research includes:

• Consultation and examination by a proctologist or gastroenterologist.
• For women – consultation and examination by a gynecologist.
• The procedure of irrigoscopy (with the help of an enema, the intestines are filled with a substance with a certain composition and an X-ray examination is carried out).
• Colonoscopy procedure (using special equipment that is inserted into the anus to examine the intestines).

A gastroenterologist may, depending on the situation, prescribe:

• Submit cal.
• Make an ultrasound of the abdominal organs.
• Undergo an examination of the motor function of the intestinal walls.
• Refer for a consultation with another doctor (neurologist, endocrinologist, etc.).

Treatment of constipation

With constipation, which is episodic, do not worry. In extreme cases, you can take a laxative. It should be remembered that you can not use a laxative more than 2 times, you do not need to get used to it. Its frequent use can lead to injury to the intestinal walls. You also need to rethink your diet. It is important to include more dietary fiber (vegetables, bran and fruits) in the diet. You should drink at least 2 liters of fluid daily. If this does not help within a day, you should immediately consult a doctor. He will prescribe the necessary tests and treatment.

Prevention of constipation

To prevent the formation of stagnation in the intestines, one must carefully monitor the diet, which should consist of vegetables, black bread, fruits and other foods that prevent constipation. Drink plenty of clean water (this does not include tea, coffee, juices, compotes). Be sure to lead an active lifestyle, exercise regularly. Walk at least 2 hours a day. You also need to do a warm-up for 10 minutes, if the work is “sedentary”.

GastroenterologistGastroenterologist (Clinic in Krasnogorsk) Gastroenterologist (Clinic in Mytishchi) Gastroenterologist (Clinic on Leninsky) Gastroenterologist (Clinic in Varshavka) Gastroenterologist (Clinic in Troitsk) Gastroenterologist (Clinic in Korolev)

GastroenterologistGastroenterologist (Clinic in Mytishchi) Gastroenterologist (Clinic in Krasnogorsk )Gastroenterologist (Clinic in Troitsk)Gastroenterologist (Clinic in Varshavka)Gastroenterologist (Clinic in Leninsky)Gastroenterologist (Clinic in Korolev)PediatricianPediatrician (Clinic in Mytishchi)Pediatrician (Clinic in Krasnogorsk)Pediatrician (Clinic in Troitsk)Pediatrician (Clinic in Varshavka)Pediatrician (Clinic on Leninsky) Pediatrician (Clinic in Korolev)

What should I do if my child has constipation?

Parents often ask: Is daily but hard stool constipation? A rare, but not bringing discomfort – a variant of the norm? Many parents face this problem: up to 30% [1] of children are familiar with constipation. We will discuss this important topic in more detail with children’s gastroenterologist Nikitin Artem Vyacheslavovich and pediatrician Miroshchenko Oksana Alexandrovna.

Normal stool frequency

There is no single norm for all children: the frequency of stool depends on age, diet and the presence of diseases or intolerances. For example, up to two years of age, bowel movements can occur from three times a day to once every few days, and children older than two go to the toilet, on average, once a day.

Stool frequency is not the only indicator for diagnosis. The child can regularly go to the toilet once a day, while the stool will be hard: this is also considered constipation.

Constipation classification

Constipation is a violation of bowel movements, in which it is impossible to completely empty the intestines.

Depending on the reasons, they are:

• primary – due to congenital or acquired anomalies of the colon;
• secondary – as a result of diseases, such as Crohn’s disease, or side effects from drugs;
• idiopathic – due to impaired motility of the colon, which arose for unknown reasons.

According to the nature of the course, constipation is divided into:

• acute when there is no bowel movement for several days;
• chronic, when symptoms persist for several months.

Causes

In 95% of cases, constipation is not associated [2] with diseases or malformations. The most common causes of constipation in children are malnutrition, food intolerances, and psychological factors. Read more about the causes – from common to rare.

No defecation skill

Not all babies are born with the ability to empty their bowels. At first, there may be no coordination between the pelvic floor muscles and the anal sphincters. Therefore, when signals are sent to the brain that it is time to empty, the baby blushes, screams and cries. When the baby still manages to go to the toilet, he calms down.

This condition is called infantile dyschezia. It occurs in children in the first months of life and usually resolves by six months. It is impossible to influence dyschezia, but it is important to exclude other diseases, so it is better to consult a doctor at the first symptoms.

Adaptation to complementary foods

When complementary foods are introduced, the gastrointestinal tract is forced to adapt to new types of food. Because of this, constipation may occur, but, as a rule, they pass after a few days.

Food intolerance

In the first year of life, a baby may develop an allergy to cow’s milk protein or celiac disease – gluten intolerance. Constipation is one of the symptoms of intolerance.

Nutrition errors

Part of constipation occurs due to malnutrition, for example, the diet is high in carbohydrates and low in fiber or almost no water. In this case, it is enough to add more vegetables and fruits to the menu and the stool will return to normal.

A mother with a nine-month-old girl once came to our clinic. The child could not go to the toilet for three days. We found out that the diet is low in fiber and made recommendations. Immediately after the visit to the clinic, the mother fed the baby with a lot of vegetables, and on the same day she managed to go to the toilet.

Psychological factor

Stress can act as a trigger and break the chair. For example, once a child felt pain during a bowel movement and now he is afraid that this will happen again. Out of fear, he holds back his stool and starts a vicious cycle: the longer he endures, the harder the feces become, which means the more painful bowel movements.

Another common example. At first, the child is uncomfortable going to the toilet in kindergarten, so he endures home. The feces thicken, defecation becomes painful, and the kindergartener begins to consciously avoid it.

It is necessary to treat such constipation not only with a gastroenterologist or pediatrician, but also with a psychologist.

I will give an example from practice. The boy went to first grade and around this time he began to have abdominal pain and loose stools five to seven times a day. For several months, the pediatrician and gastroenterologist at the place of residence tried to treat the child, and then they were sent to the hospital with a diagnosis of colitis. This is a prolonged inflammation of the colon or rectum.

We examined the boy: the left half of the abdomen turned out to be dense, like a gas cylinder. The sigmoid colon was clogged with fecal stones – an accumulation of hardened feces. And loose stools arose due to the fact that feces could not freely pass through the intestines and tried to seep along the edges. This confused the doctors, because it looked like the symptoms of colitis.

The patient was able to be helped conservatively: siphon enemas – repeatedly injected with a lot of fluid, and rectal stimulants, such as microenemas or glycerin.

Postinfectious constipation

After a viral illness, irritable bowel syndrome may begin with diarrhea or, conversely, constipation. This condition will pass on its own, but it is important to adhere to the regimen and principles of a healthy diet:

• include plenty of fiber in your diet: legumes, vegetables, fruits, whole grains and bran;
• eat less convenience foods, dairy and meat products;
• drink plenty of fluids;
• exercise regularly;
• do not ignore the urge to defecate;
• try to go to the toilet regularly and on schedule.

Diseases and developmental anomalies

In 5% of cases, constipation in children occurs [3] due to diseases or pathologies of the intestinal structure. For example, due to Hirschsprung’s disease – a congenital deficiency of the nerve plexuses of the colon wall. In children with this disease, peristalsis is weakened or absent, so feces pass through the intestines with a delay, and the affected sections of the intestine expand. The disease is amenable only to surgical treatment – resection of the affected area of ​​the intestine.

Another cause of constipation is the lengthening of the sigmoid colon. For some, this structural feature does not affect bowel function, while for others it causes problems with defecation. In such a situation, add foods with a laxative effect and fiber to the diet and exercise.

Less common are anomalies in the development of the anus or anal canal, for example, atresia – the absence of the anus and the infection of the rectum.

Sometimes constipation occurs due to adhesions after surgical interventions on the rectum and anal canal. And sometimes because of a complication of another disease.

A 13-year-old boy was admitted to a Moscow hospital, who, in terms of height and weight, looked like a junior schoolboy. For 8 years of his life he suffered from constipation: he went to the toilet every three or four days. In the clinic he was treated with suppositories and laxatives, but he was never referred to a proctologist. Our colleague from the hospital was the first to examine a teenager’s rectum. It turned out that the boy has Crohn’s disease – a serious disease that provokes an inflammatory process, the appearance of ulcers and scars on the intestinal mucosa and leads to a delay in physical and sexual development. With Crohn’s disease, a complication can develop – stenosis (narrowing) of the anal canal, due to which constipation occurs. The boy managed to be helped: he was prescribed treatment and achieved remission. Now, fortunately, nothing bothers him.

Symptoms

Constipation has several diagnostic criteria [4]. The main symptoms of constipation in children:

• reduced frequency of bowel movements;
• incomplete bowel movement;
• dense “sheep” feces in separate fragments;
• painful defecation.

But in order to make a diagnosis, it is not enough for a doctor to know about the symptoms. He must examine the patient and question him and his parents. This helps to get the full picture.

Errors in the treatment of constipation

We will not give examples of all the absurd methods of diagnosis and treatment, we will only warn about the most popular ones.

Do not donate feces for coprogram

This is an uninformative and subjective study: what you eat is what you get. In addition, the coprogram includes many studies, for example, for the presence of mucus, leukocytes and parasites. When a doctor prescribes tests for everything at once, most likely he does not know what he is looking for. According to modern clinical guidelines, the doctor should prescribe targeted studies.

Feces for dysbacteriosis are also not needed

When checking feces for dysbacteriosis, laboratory assistants analyze only 20 types of bacteria, and there are about 1000 of them in the intestine. Moreover, they are unique: each person has a different intestinal microbiota – the composition of all the microorganisms that live in it. It depends on the type of nutrition, on the way of birth, on the type of feeding and other factors. Therefore, there is no general norm for the population – the ideal number of lactobacilli and staphylococci in the intestine.

Buy fruits instead of prebiotics

Continuing the topic of dysbacteriosis, we will give you advice: do not waste money on prebiotics and probiotics. Research on their effect on constipation has not yet been completed. And while the best prebiotic is fiber – vegetables and fruits.

In recent years, lactobacilli have often been prescribed for problems with stools. There are some studies confirming the effectiveness of this treatment, but it is too early to draw conclusions: the method is still being studied.

Do not give your child prokinetics, antacids and enzymes

Doctors often prescribe prokinetics, antacids, and enzymes. However, their usefulness is highly questionable. For example, the appointment of an aluminum phosphate antacid, due to the composition of the drug, can aggravate constipation, and magnesium-containing antacids can only be taken from 6 years of age.

When prescribing prokinetics – drugs that increase the motility of the gastrointestinal tract, you need to clearly understand the nature of constipation. If problems arose against the background of adhesive disease after surgery, the appointment of the prokinetic “Trimebutin” may be justified.

Enzyme therapy also has clear indications for the appointment, in some cases, uncontrolled and unreasonable intake of enzymes can increase constipation.

When to see a doctor

Acute constipation that is left untreated for three months develops into chronic constipation and may recur for the rest of your life. Therefore, if you notice alarming symptoms, take your child to the doctor.

Here are the red flags that require expert advice:

• Constipation has occurred not once, but periodically recurs.
• Along with the difficulty of defecation, you notice a lag in physical development.
• Nausea and vomiting or abdominal pain occur in parallel with constipation.
• Blood in stool. It can talk about an anal fissure, a polyp, or a rupture of blood vessels.
• It is scary and painful to go to the toilet.
• Neoplasms appeared on the buttocks, for example, boils or fistulas.

If you can’t quickly make an appointment with a doctor, and the child cannot go to the toilet on his own, you can give him a microclyster. But only if there is no blood.

Remember that microenemas are not a cure, and if constipation episodes recur, see your doctor.

Diagnostic methods

In addition to collecting an anamnesis, the doctor may use other diagnostic methods:

• examination of the patient;
• palpation of the abdomen to detect or rule out bloating, spasms, enlargement of the sigmoid colon;
• digital rectal examination. The doctor evaluates the condition and filling of the rectum, the tone of the sphincter and the integrity of the mucosa;
• Abdominal ultrasound. Shows signs of inflammatory processes, anomalies in the structure of the digestive tract, suspicious neoplasms;
• radiography. Shows signs of intestinal obstruction.
• tests. For example, blood biochemistry;
• sigmoidoscopy or colonoscopy: to exclude organic pathology and intestinal tumors.

Methods of treatment

The doctor prescribes the treatment of constipation in children after he has found the cause. First of all, you need to remove this trigger. If it is stress, take the child to a psychotherapist, if food intolerance, remove irritating food from the diet.

Help for a child with constipation can be provided by:

• laxatives – increase intestinal peristalsis;
• antispasmodics that relax smooth muscles and facilitate bowel movements. Also relieve pain in the intestines;
• rectal suppositories with glycerin soften feces;
• microclysters soften the feces and remove them from the rectum.

Prevention

My colleagues and I notice an unhealthy trend: patients are ready to be treated, but not prevented. Many people find it easier to take a course of pills than to change their lifestyle. But medicines are a temporary tool that makes it possible to change the daily routine and nutrition. Most stool problems, if they are not associated with developmental abnormalities or other diseases, can be overcome without medication. We’ll tell you exactly how.

Adjust the diet

The first rule is to drink plenty of fluids, preferably clean drinking water or mineral water [5]. Usually, Donat Mg water with a high magnesium content or Zajechitska bitter water is prescribed at the rate of 8 ml per 1 kg per day. Drink three times a day 20 minutes before meals.

The second rule is to consume a lot of fiber – 50% of the daily diet. A diet for constipation in children should be based on vegetables, fruits and greens.

The third is to limit the foods that hold the chair together. For example, rice and semolina.

Exercise regularly

Physical activity for at least four weeks helps in 50% of cases of constipation [6]. Choose activities to do with your child. For example, simple exercises for the muscles of the pelvic floor: rolling, goose step. Or any outdoor games that the child likes. The main thing is regularity.

Go to the toilet at the same time

It is important to train your bowels to empty them at the same time. Best of all – 15-45 minutes after breakfast.

It is advisable to accustom the baby to the regimen from an early age. But if it didn’t work before, try now. Teach him in a playful way: read fairy tales, for example, about poop travels or give a game to develop fine motor skills for 10-15 minutes.

Place a small table with toys next to the potty or toilet. It is important that these toys are only in the toilet. Then the baby will form a connection:

to play with these toys, I have to go to the toilet and poop. So he will have an interest in the toilet, and over time, the habit of visiting him at the same time can be fixed.

Do not put pressure on the child

In this case, you do not need to sit on the toilet until the victorious. Failed in 15 minutes – try again after lunch. Do not force the child to push and by all means empty the intestines. The anal sphincter can be overstressed, causing a fissure, and the psychological pressure will cause stress and fear of the toilet.

If the baby is used to the diaper and is afraid to go to the potty, put him on the potty in the diaper: so the addiction will be gradual. Or buy a musical pot: it plays a tune when something hits the bottom.

Teach correct posture

The most comfortable position for defecation is squatting [7]. This makes it easier for the stool to move down to the anus. On the toilet, the desired position can be adopted using the footrest.

It is important that the child is comfortable to sit and does not have to tuck his legs under him or hold his hands on the rim of the toilet.

Perform biofeedback therapy

Use the biofeedback mechanism (BFB), a modern technique that teaches the patient to control the muscles of the pelvic floor [8]. A sensor connected to a computer is placed in the rectum. A game is broadcast on the screen and in order to perform an action in it, for example, jump over a fence, the child must strain his muscles.

Biofeedback therapy well relieves spasm of the rectum or sigmoid colon and helps strengthen the muscles of the pelvic floor. Unfortunately, the method is not yet widely used. To use it, see your doctor.

Conclusions

• With proper prevention, most constipation can be managed. But prevention is a long, meticulous, methodical process that does not tolerate slack. There must be a system.
• Do not look for magic pills that will help in a few days. Without involving parents in the problem, the problem will not be solved.
• Make your child’s diet varied. A diet with a small amount of allowed foods is a temporary measure with clear indications. On an ongoing basis, on the contrary, you need to eat as varied as possible.
• Don’t be afraid to do microenemas as an emergency. The main thing is that they do not become part of the daily routine. If the doctor has prescribed a course of laxatives, follow the dosage: it is selected individually and at first it may be higher than recommended in the instructions.
• Don’t take your child’s constipation as a temporary problem. Functional disorders accompany us through life.
• Persistent constipation in a child may be a symptom of another disease, so be sure to consult a doctor.

Sources:

1. S. Rajindrajith, Constipation in Children: Novel Insight Into Epidemiology, Pathophysiology and Management, 2011

2. MR Good, Patient education: Constipation in infants and children (Beyond the Basics), 2021

3. Constipation // Mayo Clinic

4. Rome IV criteria for the diagnosis of functional constipation in children, UpToDate

5. Eating, Diet, & Nutrition for Constipation // NIDDK, 2018

6. th.