Calgary Herald - Calgary Herald New Condos - - Weekend Life - DR. PETER NIE­MAN

Constipati­on in chil­dren costs the tax­payer mil­lions of dol­lars ev­ery year. It is re­ally a sim­ple is­sue that should never hap­pen to be­gin with, and it blocks (no pun in­tended) the flow of health­care re­sources to other ar­eas.

In many cities all across Canada, the wait times to get seen by a gas­troen­terol­o­gist or a pe­di­a­tri­cian are longer than it should be — par­tially be­cause of constipati­on.

Not so long ago, I found my­self with a group of pe­di­a­tri­cians in a chil­dren’s hospi­tal. We were get­ting an up­date on what is be­ing done to help kids who are con­sti­pated. Much de­tails were pro­vided on the in­ter­na­tional clas­si­fi­ca­tion of constipati­on and the best ways to treat it.

It just struck me at the time that if the body was cre­ated dif­fer­ently and if fam­i­lies con­sumed more fi­bre, this pesky is­sue would never be a med­i­cal prob­lem and the manufactur­ers of med­i­ca­tion to treat it would go out of busi­ness.

A full blad­der tells us it is time to empty it. We can — for what­ever rea­son — de­cide not to do that, but only up to a point.

How­ever, the bow­els were de­signed dif­fer­ently. When we get the urge, and we de­cide for what­ever rea­son to not obey the body’s mes­sage, the rec­tum fills up and ex­pands.

Plum­bers are of­ten the ones to di­ag­nose constipati­on in a fam­ily.

Not so long ago, a par­ent of one of my pa­tients ex­plained that her son reg­u­larly passes fe­ces the size of a pop can.

It is not un­com­mon to get even big­ger than that and then the toi­let gets blocked in no time.

When I was a new pe­di­a­tri­cian 33 years ago, I got a call from a mom at 2 a.m. about a con­sti­pated tod­dler.

It sur­prised me, since constipati­on is not an acute is­sue.

How­ever, as is the case so of­ten with huge fe­ces, the rec­tum can rip and bleed. The sight of blood from a child’s bum at any time of the day or night can send many par­ents in a frenzy.

Like a dog chas­ing its tail, it does not mat­ter how fast he runs, he will only go in cir­cles.

Constipati­on, too, has fam­i­lies go­ing in cir­cles — the more one holds stool in, the big­ger it gets over time, and the big­ger it gets, the more one holds back when there’s an urge to go.

The so­lu­tion is sim­ple but not easy: empty the rec­tum be­fore it builds up and then keep the stools soft.

Stool soft­en­ers cre­ate an in­come to manufactur­ers of close to a bil­lion dol­lars an­nu­ally. Many par­ents worry that the child may be­come de­pen­dent on them. If the right soft­en­ers are used, this will not hap­pen.

One such prod­uct is known as PEG 3350 and most pharmacist­s can di­rect fam­i­lies on what kind of prod­uct to use. No­body wants to use med­i­ca­tion for a long time, and thus when it works, some fam­i­lies stop it af­ter two weeks.

That is too soon. It takes time for the rec­tum to shrink and, in some cases, the med­i­ca­tion must be used for a few months to avoid a vi­cious cy­cle.

Den­tal hy­gien­ists tell close to

99.9 per cent of their pa­tients to floss more of­ten; di­eti­tians tell

99.9 per cent of their pa­tients to eat more fi­bre. Num­bers are thrown out, such as a min­i­mum of 30 to 40 grams per day. In 40 years of be­ing a doc­tor, I have not met one fam­ily where they use math­e­mat­ics to cal­cu­late their fi­bre in­take. The so­lu­tion is rather sim­ple: be­come ve­gan or fol­low the new Food Guide, which un­der­scores more plant-based foods and less dairy and meat.

A book highly rec­om­mended by ex­perts in the field is The

Ins and Outs of Poop, by

Thomas DuHamel.

Dr. Nie­man has worked as a pe­di­a­tri­cian since 1987. He hosts a web­site, healthykid­, and has com­pleted 111 marathons.

While no­body wants to use med­i­ca­tion for a long time, there are qual­ity prod­ucts out there to help treat child­hood constipati­on. ISTOCKPHOT­O

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