10 common causes of constipation in children in Kenya


  1. Bananas – Bananas are NOT fruits. A huge percentage of children with constipation eat one or more bananas daily or every other day. Bananas are sweet, make one feel full quickly and children love them. As a result, caregivers tend to give them a lot as the children ask for them. Children below five years should not eat more than one banana per week. Preferably, these children should eat half a banana on each of two days in a week that should not be consecutive. The small sweet bananas are worse culprits than the regular big bananas.
  2. Lack of roughage in diet – Roughage is essential in any diet and also for children. Children should eat their greens (kales/spinach/cabbage) as well as fruits like mangoes and pawpaws which are rich sources of roughage. They should also be fed on cereals like weetabix . These foods should be part of their daily diet so that they have regular bowel movement.
  3. Lack of bulk forming foods – children who eat junk or are constantly on fluids like milk or juices are usually full but end up not consuming enough food to form bulk of stool. Presence of bulk in the intestines stimulates peristalsis and hence encourages daily or more regular bowel movements. Children who eat little may have bowel movements once or twice per week. Thus, caregivers must ensure that children eat three meals and two snacks as required. Fluids only can be given as snacks if the child is not very hungry but should not be given as meals.
  4. Defective bowel training – Children should be trained to go to the toilet the moment they feel like defecating. Postponing of defecation should be avoided unless it is unavoidable. School going children should be trained to go to the toilet once a day minimum and to go in the morning before school or in the evening after school. In school, children will postpone defecation so as not to miss out on other activities. In addition, many children are unable to defecate in strange environments so encourage use of the toilet at home.
  5. Medications – Children on medically prescribed drugs as well as people who self prescribe supplements for their children should be aware of possible side effects. Any medications containing calcium can cause constipation. In addition, antacids can also cause constipation due to their aluminum content. Iron supplements can also cause constipation. So beware of constant use of supplements to boost immunity or just because someone else is doing it. Supplements should be given if and when needed.
  6. Food intolerance – Food intolerance is different from food allergy. Allergy means that the person affected reacts to an aspect of the food consumed. These are usually proteins like milk and eggs. On the other hand, intolerance means that the body is not able to handle some foods. For instance, people who are lactose intolerance lack the enzyme needed to digest milk. These people will not break down in rash or go into shock when they consume milk. Instead, they have abdominal pains, constipation or diarrhea, vomiting and dyspepsia. Hence, children with chronic constipation should have their diet assessed for possible causes.
  7. Immobility –Any condition that impedes free movement of the child can predispose to constipation. This can range from cerebral palsy to any form of paralysis or illness that results in children being bed ridden for long periods of time..
  8. Parasitosis – Heavy infestation with worms can predispose to constipation sometimes due to the sheer presence of the worms. There have been instances of children going into complete obstruction of their bowels due to worms. It is easy and affordable to de-worm children regularly. Twice a year is usually adequate for children living in relatively hygienic environments and can be more often if the living standards are low.
  9. Irritable bowel syndrome – this is a specter of illness that result due to one’s body’s immunity reacting to the foods it experiences passing through the intestines. This results in diarrhea usually but can also cause constipation. This is a diagnosis made by pediatric gastroenterologists after colonoscopy is done and the specimen sent for histology. Children with chronic intestinal discomfort and symptoms should be evaluated by a pediatric gastroenterologist.
  10. Congenital problems – Problems that result in incomplete or faulty development of the gastro-intestinal system can affect movement of bowels leading to constipation. Hence any child with chronic constipation should be thoroughly investigated for cause.

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