Chronic constipation is a crappy problem – one common among all children, but especially prevalent among children special needs. Pediatric physical therapy at FOCUS Fort Myers may help, using exercises to strengthen pelvic muscles and improve posture.

We know this can be an uncomfortable issue to discuss, but if it’s causing your child pain and difficulty on a regular basis, it’s one that requires attention because it’s essential to good health. The Journal of Pediatrics reports constipation among children with autism is associated with increased emergency department visits and inpatient admissions. Depending on the underlying cause, pediatric physical therapy may help alleviate the problem. Occupational therapists, ABA therapists and even speech therapists can also collaborate on solutions.

Constipation involves either the inability to pass stool or problems that make it not as easy or frequent as one would like.

One analysis published in the journal Gastroenterology examined more than 50 school-age children suffering from functional constipation, all of whom were receiving the “standard” treatment for chronic constipation, which included potty training, education and laxatives. Half were randomly chosen to also receive pediatric physical therapy. Six months later, more than 90 percent of the children who got physical therapy no longer suffered from constipation, compared to about 60 percent of those who didn’t get physical therapy.

Special Needs Conditions Associated With Constipation

As explained by a state Special Needs Medical Services department, children who have atypical skeletal muscle tone and poor coordination “down there” (such as those with cerebral palsy) or difficulty with things like eating certain foods or sitting on the toilet may have a hard time with this. Those with neurological problems may have a tougher time because abnormal tone doesn’t allow the bowel to work correctly (and the longer stool is in the bowel, the harder it may get, making it even more painful). Those with spinal cord injuries don’t have typical sensory and motor function in the organs and muscles involved, and thus they may not feel the need to go and stool doesn’t move normally along the tract of the intestine.

Symptoms of constipation you’ll want to watch for include:

• Incomplete or infrequent bowel movements;
• Pain during bowel movements;
• Hard, ball-shaped stools;
• Poor appetite;
• Irritability/ other unexplained change in behavior;
• Abdominal pain or distention.

Ways Our FOCUS Therapists Can Help

First, let’s talk physical therapy. Children with functional constipation may have weak pelvic floor muscles, which can be because of weak pelvic floor muscles (sometimes due to poor posture) or the fact that they’re sitting in an unstable, awkward position on a seat that’s designed for adults. (And of course there are the issues we mentioned earlier too.)

Physical therapists can help design exercises that can improve posture, increase pelvic muscle strength and ultimately ease constipation. We can help them practice with proper posture and work on exercises that will contract and relax those muscles and help them become more aware of the sensations they’re experiencing that indicate they need to use the bathroom.

Of course, diet plays a significant role too. Healthy digestion necessitates a diet that is rich in fiber and also fluids. If there isn’t enough fiber (like those found in fruits, vegetables and whole grains), too much dairy and not enough fluids in your child’s diet, they are likely to experience gastrointestinal problems. If the reason has to do with a condition like autism that involves extreme aversion to all but a few foods, we can approach it with the SOS Feeding Therapy Approach (in which several of our occupational therapists and speech therapists are trained). You can read more about this method in our FOCUS Occupational Therapy Blog. It’s a play-based, no-pressure therapy to introduce and encourage them to try new foods.

If  constipation is a problem with which your child is regularly struggling, please don’t be shy about bringing it up. We want your child to be healthy and happy – and toileting success is part of that. Let us help you map out the best individualized strategy for your child.

FOCUS offers pediatric physical therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

5 Common Mistakes (and Solutions) When Dealing with Kids’ Chronic Constipation, Sept. 1, 2016, By Melanie Potock, MA, ASHA: American Speech-Language-Hearing Association

More Blog Entries:

Fort Myers ABA Therapy Helps Target Toilet Training, April 27, 2018, Fort Myers Pediatric Physical Therapy Blog