Constipation in the UK is no joke and it’s time we got to the bottom of it.It’s thought one in seven adults and one in three children are impacted by the condition – and the financial burden on the NHS is huge. A Cost of Constipation report in 2020 suggested 77,000 people were being admitted to hospital each year with the issue, costing the NHS £168 million. Of these, children and young people account for 18% of admissions.For nurse and potty learning expert Rebecca Mottram, constipation is a “significant health issue in the UK”, with many cases going unnoticed. “Nine out of 10 cases that I treat in my consultancy practice involve children with constipation, and this is usually undiagnosed,” she told HuffPost UK.“This is often due to a lack of awareness about the signs of constipation in children, which parents and caregivers may misinterpret or overlook.”The nurse suggests that, as a result, constipation often remains untreated until it becomes severe – at this point, children might require specialist care or even hospital admission. “Constipation in children presents differently to adults and most parents are completely unaware of what to look for,” said the nurse, who previously shared 16 distinct signs of constipation for caregivers to be on the lookout for. Why is constipation such a problem for our kids?Sarah Timms, head of family services and support at children’s bowel and bladder charity ERIC, told HuffPost UK that for the majority of children “there is no underlying physical reason”.Yet there can be many causes, she said, such as not drinking enough or a poor or limited diet. We know children with additional needs or a learning disability are also more likely to become constipated and underlying conditions such as Hirschsprung’s Disease or Spina Bifida can also impact the bowel.“These are usually picked up soon after birth but are one of the reasons that children should be examined by a GP when constipation is diagnosed,” added Timms.Constipation is also common around the times of potty training and starting school. Timms explained: “A change in routine can make children more anxious which means they find it more difficult to relax on the toilet.”Mottram said that based on her observations over the past decade, during which she has supported hundreds of parents in resolving potty training challenges, she has found the widespread use of the “one-step” potty training method — where children are expected to potty train within just a few days — “is closely linked to an increased risk of poo withholding”.“I estimate that around 40% of children may struggle with such a rapid transition, often leading them to withhold bowel movements, which in turn increases the risk of constipation,” she said.When children stop the urge to do a poo it’s easy for them to get trapped in a vicious cycle of withholding. When their poo hurts or they are scared of going to the toilet, they find it hard to relax and are anxious it will hurt. They then avoid going for a poo and it hurts even more – cue: constipation.Both Mottram and the charity ERIC are proponents of starting “potty learning” earlier in childhood, around the age of 18 months, to try and get children used to listening to their bodies from an early age,“There are 40 different skills your baby needs to learn and put together to become potty trained, and so it’s important to start ‘potty learning’ early – that’s things like introducing them to the potty, involving them in nappy changes and talking to them about wee and poo,” said Timms.“You don’t need to wait for ‘signs of readiness’ to do this – prepare your child by teaching them the skills they need.”You could start by introducing your baby to the potty as soon as they can safely sit up unaided, for example.“The more practice and help a child gets, the easier it will be when it’s time to stop wearing nappies,” said Timms.“We want babies and children to be able to relax on the potty, so just sitting with their nappy on, looking at a book, will encourage this. Try to be positive and praise and reward them for potty sits – not just when they have done a wee or a poo.”What can parents do to encourage more poo?First of all, if you’re reading this and you think your child might be constipated, take them to a GP. The longer your child is constipated, the more difficult it can be for them to get back to normal – so early intervention is key.“Constipation needs to be diagnosed by a GP and treated with laxatives,” said Timms. Kids who are constipated might be: doing fewer than three poos a week; having large hard poos or small pellet poos; experiencing straining or pain when pooing; bleeding after a large hard poo; or have tummy ache or a poor appetite that gets better after a poo.They might also experience soiling in their pants which is where runnier poo manages to escape around the outskirts of the larger, harder poo which is stuck. You can find a more extensive list of symptoms here. “Look at our Poo Checker and have conversations with your child about their poo,” said Timms. “You can even print off our Poo Checker and put it in the bathroom to get the conversation going!”To prevent constipation, experts advise a well-balanced diet (plenty of fibre, fewer processed foods) and keeping tabs on how much your child is drinking. According to ERIC, they should be aiming for six to eight cups of water or diluted squash per day. Exercise is also important for encouraging the bowel to squeeze, so try to get your child moving regularly. It’s also crucial to help them get to the loo at the right time, which is easier said than done when they’re at school. Timms explained that “the bowel squeezes most strongly 20-30 minutes after eating, so getting into the routine of a relaxed toilet sit around this time is a good idea”.For children who are at school, ideally this means going to the toilet after lunch and possibly after they’ve had a run around on the playground, too. “What we don’t want is them holding their poo in all afternoon, trying to wait until they get home, as withholding can lead to constipation,” said Timms. “We also need to ensure they have access to drinking water throughout the day.”Body awareness is crucial – and can begin from a young age, with children encouraged to talk about how their body feels, and not feeling ashamed to discuss wees and poos. Open and honest conversations are key. It might help to discuss what poo is and where it comes from. Show them their own poo in the toilet and talk about it, or show them your own poo or that of a sibling (if they want to see it).Mottram added: “Being more aware of bowel and bladder health from an early age and recognising signs of potential issues could help spot problems before they develop and allow for earlier intervention, leading to better long-term outcomes for children’s health.”Related…Babies Can Ditch Nappies Sooner Than You Think — A Potty Training Expert Explains HowI’m A Doctor — This Breathing Technique Can Relieve ConstipationThese 2 Common Fruits Can Help Ease Constipation FastI’m A Doctor – Adding This 6p Ingredient To Water Can Help Cure Constipation Parents, Health, children’s health, regular, poo, constipation, health, childrens-health HuffPost UK – Athena2 – All Entries (Public)
Constipation in the UK is no joke and it’s time we got to the bottom of it.
It’s thought one in seven adults and one in three children are impacted by the condition – and the financial burden on the NHS is huge.
A Cost of Constipation report in 2020 suggested 77,000 people were being admitted to hospital each year with the issue, costing the NHS £168 million. Of these, children and young people account for 18% of admissions.
For nurse and potty learning expert Rebecca Mottram, constipation is a “significant health issue in the UK”, with many cases going unnoticed.
“Nine out of 10 cases that I treat in my consultancy practice involve children with constipation, and this is usually undiagnosed,” she told HuffPost UK.
“This is often due to a lack of awareness about the signs of constipation in children, which parents and caregivers may misinterpret or overlook.”
The nurse suggests that, as a result, constipation often remains untreated until it becomes severe – at this point, children might require specialist care or even hospital admission.
“Constipation in children presents differently to adults and most parents are completely unaware of what to look for,” said the nurse, who previously shared 16 distinct signs of constipation for caregivers to be on the lookout for.
Why is constipation such a problem for our kids?
Sarah Timms, head of family services and support at children’s bowel and bladder charity ERIC, told HuffPost UK that for the majority of children “there is no underlying physical reason”.
Yet there can be many causes, she said, such as not drinking enough or a poor or limited diet. We know children with additional needs or a learning disability are also more likely to become constipated and underlying conditions such as Hirschsprung’s Disease or Spina Bifida can also impact the bowel.
“These are usually picked up soon after birth but are one of the reasons that children should be examined by a GP when constipation is diagnosed,” added Timms.
Constipation is also common around the times of potty training and starting school. Timms explained: “A change in routine can make children more anxious which means they find it more difficult to relax on the toilet.”
Mottram said that based on her observations over the past decade, during which she has supported hundreds of parents in resolving potty training challenges, she has found the widespread use of the “one-step” potty training method — where children are expected to potty train within just a few days — “is closely linked to an increased risk of poo withholding”.
“I estimate that around 40% of children may struggle with such a rapid transition, often leading them to withhold bowel movements, which in turn increases the risk of constipation,” she said.
When children stop the urge to do a poo it’s easy for them to get trapped in a vicious cycle of withholding. When their poo hurts or they are scared of going to the toilet, they find it hard to relax and are anxious it will hurt. They then avoid going for a poo and it hurts even more – cue: constipation.
Both Mottram and the charity ERIC are proponents of starting “potty learning” earlier in childhood, around the age of 18 months, to try and get children used to listening to their bodies from an early age,
“There are 40 different skills your baby needs to learn and put together to become potty trained, and so it’s important to start ‘potty learning’ early – that’s things like introducing them to the potty, involving them in nappy changes and talking to them about wee and poo,” said Timms.
“You don’t need to wait for ‘signs of readiness’ to do this – prepare your child by teaching them the skills they need.”
You could start by introducing your baby to the potty as soon as they can safely sit up unaided, for example.
“The more practice and help a child gets, the easier it will be when it’s time to stop wearing nappies,” said Timms.
“We want babies and children to be able to relax on the potty, so just sitting with their nappy on, looking at a book, will encourage this. Try to be positive and praise and reward them for potty sits – not just when they have done a wee or a poo.”
What can parents do to encourage more poo?
First of all, if you’re reading this and you think your child might be constipated, take them to a GP. The longer your child is constipated, the more difficult it can be for them to get back to normal – so early intervention is key.
“Constipation needs to be diagnosed by a GP and treated with laxatives,” said Timms.
Kids who are constipated might be: doing fewer than three poos a week; having large hard poos or small pellet poos; experiencing straining or pain when pooing; bleeding after a large hard poo; or have tummy ache or a poor appetite that gets better after a poo.
They might also experience soiling in their pants which is where runnier poo manages to escape around the outskirts of the larger, harder poo which is stuck. You can find a more extensive list of symptoms here.
“Look at our Poo Checker and have conversations with your child about their poo,” said Timms. “You can even print off our Poo Checker and put it in the bathroom to get the conversation going!”
To prevent constipation, experts advise a well-balanced diet (plenty of fibre, fewer processed foods) and keeping tabs on how much your child is drinking. According to ERIC, they should be aiming for six to eight cups of water or diluted squash per day.
Exercise is also important for encouraging the bowel to squeeze, so try to get your child moving regularly.
It’s also crucial to help them get to the loo at the right time, which is easier said than done when they’re at school. Timms explained that “the bowel squeezes most strongly 20-30 minutes after eating, so getting into the routine of a relaxed toilet sit around this time is a good idea”.
For children who are at school, ideally this means going to the toilet after lunch and possibly after they’ve had a run around on the playground, too.
“What we don’t want is them holding their poo in all afternoon, trying to wait until they get home, as withholding can lead to constipation,” said Timms. “We also need to ensure they have access to drinking water throughout the day.”
Body awareness is crucial – and can begin from a young age, with children encouraged to talk about how their body feels, and not feeling ashamed to discuss wees and poos. Open and honest conversations are key.
It might help to discuss what poo is and where it comes from. Show them their own poo in the toilet and talk about it, or show them your own poo or that of a sibling (if they want to see it).
Mottram added: “Being more aware of bowel and bladder health from an early age and recognising signs of potential issues could help spot problems before they develop and allow for earlier intervention, leading to better long-term outcomes for children’s health.”
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