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Home Articles REAL Health Digestive Illness About Digestive Illness
About Digestive Illness Print E-mail
Written by Susan McCreadie, MD   
Constipation (delay or difficulty with defecation) is quite common among children - some estimate up to 30% of children deal with it daily. Constipation can vary in presentation: infrequent stools, difficulty passing large-diameter stools, hard small stools referred to as “pebbles”, fecal incontinence called encopresis (where softer liquid feces leaks around hard impacted stool), or a combination of the above. 

As we grow, the amount of time it takes for food to travel through our bowels increases.  Healthy infants should produce two to three stools per day; by 2 years of age two stools per day; and by 4 years of age children should produce at least one stool per day. 

Constipation Convential Medicine Viewpoint: Fewer than 5 percent of children with constipation can be linked with a cause, such as anatomic malformations (think plumbing not hooked up correctly or something blocking the outflow), nervous system abnormalities (think electrical wiring not connected correctly), or other reasons including hypothyroidism, diabetes, cystic fibrosis, celiac disease (gluten enteropathy), and cow’s milk intolerance. So the vast majority of children suffer from “functional constipation” where no anatomic or biochemical cause can be identified. Children with constipation are treated with oral or rectal medication to remove hard impacted stool, then started on a regimen of laxatives, behavior modification, and dietary changes to increase intake of fiber and fluids even though evidence supporting these diet changes are weak.
 
Chronic diarrhea, defined as persistent loose or watery stools, is less common than constipation. In all cases of diarrhea, not enough water is absorbed by the intestines, but the reason why varies. A small percentage of children have an identifiable cause for their diarrhea, such as infection, immune deficiency (HIV), celiac disease or gluten-sensitive enteropathy, ulcerative colitis, Crohns disease, cow’s milk intolerance, or cystic fibrosis to name a few. However, for the vast majority of children suffering from diarrhea, no underlying reason is identified. These children are referred to as having functional diarrhea. 

Diarrhea Convential Medicine Viewpoint: Nearly all these children establish normal bowel patterns by 4 years of age, and apart from reducing fruit juice intake (fruit juice causes more fluid to be pulled into the intestinal lumen), dietary changes are not considered helpful. 

Holistic Viewpoint: Food protein intolerances - particularly cow’s milk and gluten - are often overlooked as a reason for “functional” constipation and/or diarrhea. (Note: Cow’s milk intolerance can also present with other GI disturbances such as gastroesophageal reflux disease (GERD), enterocolitis (diarrhea), or cause blood in stool.)  Many children with constipation and/or diarrhea have intestinal dysbiosis, which is a microbial imbalance within the gut. What is that you say?  Our digestive system should be armed with healthy gut flora. These microorganisms together are busy doing a host of “chores” for our body including fermenting food, training our immune system, keeping growth of harmful pathogenic organisms in check, producing vitamins and hormones for our body, to name a few. The gut flora have been called the “forgotten organ”. We never forget our heart beats, our lungs breath, our brain thinks, but we do forget that our digestive tract has ten times the amount of microorganisms (bacteria, fungi and protozoa) than cells in the entire body and plays a major role in the normal functioning of our body.

Susan McCreadie, MD is a Holistic Pediatrician and co-founder of nourishMD. She shows parents how to find REAL health for their child, so they can stop treating their child's symptoms and instead find solutions that help their child heal from the inside out.