Many of our autistic children struggle with constipation. As a whole, children on the spectrum are more likely to have GI issues than their neurotypical peers. However, identifying constipation in your child isn’t always as simple as it seems.
Recognizing the Signs of Constipation
When you think about constipation you likely imagine a child straining to poop and having hard and infrequent bowel movements. While this certainly describes constipation in a child, it is not the only way the issue presents itself.
- Loose stools: A constipated child may have loose stools. It’s easy to see loose stools and dismiss the idea of constipation as the cause however when we look at how the body works, this side effect makes sense.
When a child is constipated they tend to have large, hard, and painful bowel movements. To avoid this painful experience, many children hold their stool in. This further complicates the problem. When stool sits in the colon, the liquid from the stool is absorbed, making the stool even harder. This makes bowel movements even more painful and perpetuates the cycle.
As the hard stool sits in the colon, there is softer stool building up behind the blockage. Sometimes this softer stool pushes around the blockage and results in a very soft or watery bowel movement. So while it may seem like your child has diarrhea, the real issue is constipation. This is typically the result of moderate to severe constipation.
- Daily but inadequate bowel movements: It is possible for your child to have daily bowel movements but still be constipated. It’s generally believed that a child should expel 8-10 inches of stool a day. If your child is pooping daily but only in small amounts, they may be experiencing constipation.
Understanding Why Constipation is a Bad Thing
Constipation seems harmless enough. Sure it’s uncomfortable, but are there real risks involved with untreated constipation? The answer is yes.
Our body gets rid of stool because it’s not useful to our body. When we hold onto that, we fail to purge the toxins and waste located within the stool. The longer the stool and those toxins remain in our body, the more it gets reabsorbed into the bloodstream via the colon. This can lead to gut inflammation and poor overall gut health.
Some less obvious risks associated with constipation are:
- Toe walking: Your child may begin toe walking in an attempt to deal with the pain and discomfort associated with constipation.
- A rise in self-stimulatory behavior
- A lack of sleep
- An increase in meltdowns
Constipation is a sign that something isn’t quite right in the GI system. It may indicate an excess, deficiency, or imbalance that needs to be addressed. It’s important to investigate the cause of your autistic child’s constipation and find ways to help.
Traditional Treatments for Constipation
There are plenty of over-the-counter treatments for constipation. Many of these interventions are useful when your child’s constipation becomes an emergency situation because they offer immediate relief. However, these traditional constipation treatments do not address the cause of constipation and therefore won’t be helpful in solving the problem in the long term.
- MiraLAX (polyethylene glycol): There are some advantages to this common over-the-counter constipation remedy. It comes in a tasteless, odorless, colorless powder that’s easy to sneak into foods and drinks. I will sometimes recommend using products like MiraLAX to disrupt the painful bowel holding cycle.
- Senna: This a stimulant laxative. MiraLAX pulls water in to soften the stool, Senna stimulates bowel movements. It is a short-term remedy that can cause cramping and dependency.
- Magnesium citrate: Similar to Senna, magnesium citrate can cause cramping, especially when given in higher doses. This over the counter sweet-tasting liquid can also increase loose stools.
- Colace: This is a stool softener and is typically used for maintenance because it doesn’t work immediately.
- Suppositories: Suppositories are inserted into the rectum and can provide rapid and immediate relief.
Natural Treatments for Constipation
I approach constipation treatment the same way I approach treating anxiety and OCD in children with autism. I always try to start with a more natural option. Luckily, when it comes to constipation treatment, there are plenty of natural interventions you can use either alone or in conjunction with more traditional treatments.
- Water: Many kids don’t drink enough water. Increasing your child’s water intake is a super simple way to address their constipation.
- Fiber: Getting your child to eat enough fiber can be challenging, especially if they’re a picky eater. Foods like fruits, vegetables, and grains (not gluten) like quinoa or chia seeds are good sources of natural fiber. However, when you increase your child’s fiber you need to increase their water intake. A high fiber diet without enough water can result in hard stools.
- Magnesium: Magnesium glycinate can be very helpful with constipation however, too much can lead to loose stools. This supplement comes in liquids, tablets, powders, and capsules, so it’s easy to find the perfect product for your child’s specific needs. To determine the correct dosage for your child I recommend “dosing to bowel tolerance.”
You can start by giving your child a half dose for 2-3 nights. Then slowly increase the dose by half over the next few days. When your child has loose stool, drop back down one dose and stay there.
- Fish oils: This foundational supplement is a good place to start for constipation treatment. Fish oils can decrease inflammation in the gut and act as a lubricant.
- Pro and Prebiotics: Probiotics, which you’re likely familiar with, are the good bacteria we need in our gut. Prebiotics are the fiber that probiotics use for food. Having the right balance of these in your gut can help alleviate constipation.
- Ready! Set! Go!: This is a combination of fruit and plant extracts to help with constipation.
- NDF Pooper: This liquid bowel mover works by lubricating your child’s intestines to encourage easy bowel movements.
- Squatty Potty: This is a half-ring-shaped bench that goes around the foot of the toilet. Your child can rest their feet on it so they’re in a better position to poop.
- Potty habits: Many times, you’ll see an improvement in your child’s regularity just by encouraging consistent potty habits. It’s a good idea to have your child get into the routine of sitting on the potty for 15-20 minutes after mealtime. Building this time into their schedule can help them relax and settle down long enough to poop regularly.
Gut health is essential to our children’s overall well-being. Whether you do it on your own or with the help of a professional, it’s important to recognize and address the signs of constipation.
Be gentle with yourself. You’re doing a great job.
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