Your Guide to Bowel Problems in Children

No one wants to see their child sick, even if it’s just temporary. For example, the occasional upset stomach or diarrhea is expected if your child is home with stomach flu or eats something that doesn’t agree with them. And often, the solution is simple — eliminate troublesome foods or recover from the stomach flu.

But sometimes, you might suspect that there’s something more going on. So, how do you determine that there’s a more serious bowel or digestive problem with your child, and how do you work toward a long-term solution?

Let’s look at some of the most common bowel problems that are found in children and their symptoms. We’ll also discuss treatment options and when you should contact a doctor or healthcare provider.

Signs of bowel and digestive problems in kids

Digestive and bowel discomfort is quite a large health category, with many temporary or underlying causes that might be contributing to your child’s tummy woes. But ultimately, you know your child better than anyone. So, if you see the following persistent symptoms, it might mean your child has a more serious digestive or bowel issue.

Constipation

To receive a diagnosis of constipation, your child must be 4 years old or older and exhibit at least two or more of the below symptoms and experience them once a week for at least 2 months. Common symptoms include:

  • constipation or fewer than three bowel movements per week
  • fecal incontinence at least once a week
  • large diameter stool, or poop, that causes toilet blockage
  • history of painful or hard bowel movements
  • Irritable bowel syndrome (IBS)

    While uncomfortable, irritable bowel syndrome (IBS) isn’t life threatening for your child, nor does it cause them additional health problems or digestive tract damage. Symptoms of IBS include:

  • abdominal pain
  • constipation
  • mucus in their stool
  • bloating or abdominal distention
  • diarrhea
  • Inflammatory bowel disease (IBD)

    Inflammatory bowel disease (IBD) is another type of intestinal disorder that can cause inflammation in your child’s digestive tract. Common forms of IBD include Crohn’s disease and ulcerative colitis.

    Common symptoms include:

  • weight loss
  • bloody diarrhea
  • abdominal pain
  • poor growth
  • anemia, or their body not producing enough red blood cells
  • fatigue
  • Unlike IBS, if left untreated IBD can create further complications such as bowel obstruction, malnutrition, and fistulas, and in more severe cases, it can contribute to colorectal cancer.

    Hirschsprung’s disease

    Hirschsprung’s disease is a condition that impacts the large intestines. While it’s always present at birth, it can sometimes take a while for symptoms to appear. Children with Hirschsprung’s disease may have trouble emptying their bowels. Symptoms can vary depending on your child’s age.

    Symptoms in newborns:

  • difficulty passing stool within the first day or two of being born
  • swollen belly, gas, or bloating
  • diarrhea
  • vomiting (may be brown or green in color)
  • Symptoms in toddlers and older children:

  • swollen belly and gas
  • difficulty gaining weight/growth delay
  • constipation
  • vomiting
  • When to see a doctor about your child’s bowel problems

    While some formal diagnoses, such as constipation, won’t be applied until certain timelines have been met, that doesn’t mean that you can’t see a pediatrician, or a doctor for infants and children, before then. For example, with constipation, if your child’s symptoms and inability to pass stool have persisted for more than 2 weeks, you’re encouraged to see a doctor.

    And especially if your child’s symptoms begin to get worse — such as developing a fever, losing weight, or refusing to eat — don’t delay scheduling your child an appointment with a physician to start the diagnostic process and work toward a treatment plan.

    Are bowel problems hereditary?

    While many people develop bowel problems without a family history of them, for some people, gastrointestinal diseases and conditions are linked to their genetics.

    According to a 2015 study that looked for a link between genetics and IBD, the research found that 15 percent of those with Crohn’s disease had a family member who has also received a diagnosis of IBD. This percentage increased to 26 percent when that family member was a sibling.

    Diagnosing bowel problems in children

    The diagnostic process used to determine if your child has a bowel problem is going to depend on what disease or condition is suspected.

    For example, childhood IBS and IBD both rely on a physical exam and a review of medical history (including family history). Depending on the results of initial reviews, a pediatrician may order a blood test, stool test, ultrasound, or even an endoscopy or colonoscopy.

    Meanwhile, a suspicion of constipation will include a medical history and physical exam. It may sometimes also require other tests, such as a barium enema X-ray, abdominal X-ray, and even a motility test, if other conditions need to be ruled out, but often a doctor will be able to diagnose constipation without further tests.

    A barium enema is also a primary tool for diagnosing Hirschsprung’s disease, but a biopsy may also be necessary for this condition.

    If you’re concerned that the diagnostic process may be stressful for your child, make sure to talk with a doctor or pediatric team so you can know exactly what their testing process will be like.

    How to solve bowel problems in children

    Similar to diagnosing bowel problems, treatment methods can vary depending on your child’s condition and the severity of it.

    Treating constipation

    While constipation in children is very common, it’s also often undiagnosed and untreated. For many children, constipation can be treated at home by boosting fiber in their diet, increasing water intake, and encouraging more physical activity. With a doctor’s supervision, stool softeners or laxatives may be occasionally used.

    Treating IBD

    IBD requires a comprehensive approach to treatment that incorporates both medication and dietary changes. The overall goal is to relieve symptoms and prevent future flare-ups to heal the intestines.

    If an infection is suspected, your child might be prescribed antibiotics. But other treatments can include:

  • anti-inflammatory drugs
  • immunosuppressive and protein blocking agents (if needed) to prevent inflammation
  • nutritional therapy to limit exposure to triggering foods
  • Treating IBS

    To treat IBS, nutritional changes are frequently encouraged, along with possibly being prescribed probiotics to help balance your child’s gut. A doctor may also prescribe a range of different medications depending on their symptoms.

    Depending on the type of IBS, your child may be prescribed medications to treat associated conditions such as constipation or even antidepressants depending on how severely the condition is impacting your child’s quality of life.

    Treating Hirschsprung’s disease

    Due to the seriousness of Hirschsprung’s disease, surgery is the most effective method for treating the condition. Depending on the severity of their condition, children may either undergo one or two surgeries to remove the unhealthy part of their colon and treat the disease.

    The gut-brain connection

    As we mentioned earlier, there’s a link between mental health and persistent bowel discomfort. At a minimum, always dealing with digestive upset can cause your child to miss out on activities, and it may manifest as them withdrawing from social settings due to embarrassment.

    You may want to offer your child the option of getting into therapy, in particular, cognitive behavioral therapy, alongside their other treatments. This will help your child to change their behavior and thought patterns, as well as understand how their mental state can impact their digestive health.

    Possible long-term complications for bowel problems in children

    Although some bowel conditions aren’t life threatening, they can impact your child’s quality of life. For example, conditions such as IBS — which usually don’t cause more concerning medical conditions — can cause children to miss out on social events, or to even find it difficult to be present in school. This can negatively impact your child’s mental health.

    Meanwhile, if left untreated, other conditions can act as precursors to more serious health complications. Even constipation, which is incredibly common in children, can manifest into bladder control issues, fecal impaction, hemorrhoids, rectal prolapse, and even anal fissures.

    Untreated IBD can lead to painful ulcers and damaging bowel inflammation. Additionally, it has been known to also cause rashes, arthritis, eye and liver problems, and slow growth and delayed puberty.

    Because Hirschsprung’s disease already prevents children from properly passing stools, leaving it untreated can be life threatening and lead to toxic enterocolitis.

    Regardless of the source of your child’s gastrointestinal distress, it’s important to get a treatment plan established with a doctor as soon as you can.

    Takeaway

    Sometimes an upset stomach or a case of diarrhea is temporary, and at other times it might be more serious. These bowel problems in children can be caused by a variety of conditions, some of which can lead to more health problems if not dealt with.

    If you suspect that your child’s tummy issues might be something more, be proactive and reach out to a pediatrician. When caught early, treatment can prevent further long-term problems that would impact your child’s quality of life.

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