How Pediatric Physical Therapy Can Address Constipation
The process of having a bowel movement involves different parts of the body, most of which are located in the pelvis. And if your child is constipated, physical therapy can help to alleviate their symptoms and ensure they have an easier time in the bathroom. My name is Reilly Peterson, I’m a physical therapist with Metro Therapy. Today, we are going to be talking about constipation and the pelvic floor.
What Is the Pelvic Floor?
If you look at a diagram of the pelvis, you can see that the hip bones look a bit like a bowl. At the base of the pelvis, you have the pelvic floor muscles, which support your organs such as your bladder and rectum.
How to Tell if Your Child is Constipated
Typically by age four, your child will have a normal adult frequency for bowel movements, which is about four to nine times per week. However, it can look different from kid to kid. Constipation happens when the stool is backed up, which might lead to a decrease in bowel movement frequency. But kids can also have a normal stool frequency and still be considered constipated.
What Causes Constipation in Kids?
There are a couple of reasons why kids can experience constipation:
Withholding – if your child has a fear of the toilet or doesn’t have access to a bathroom when they have to go, they could get in the habit of holding it in when they need to have a bowel movement.
Medications – some medications can cause constipation, which your child’s pediatrician should tell you about as a possible side effect when the medicine is prescribed.
Inactivity – being in bed for a long time due to illness or injury, or lack of movement in general can also cause constipation.
Diet – a diet lacking in fiber or enough water can eventually lead to constipation as well.
What Happens When a Child Holds in Their Bowel Movements
When constipation happens, the stool gets backed up into the rectum. And because your child keeps eating without having a bowel movement, the stool keeps piling up and eventually becomes very hard. This makes it difficult to defecate, which can lead to more backup. This leads to a vicious cycle of withholding and the stool backing up.
Symptoms of Constipation in Children
Some common constipation symptoms that you might want to look for in your kids include:
Abdominal pain, which they may complain about when they have to go to the bathroom
Excessive bloating
Straining a lot trying to push things out on the toilet
Lack of appetite
Body odor
These symptoms can occur even if your child is having normal bowel movement frequencies or stool consistencies. So if you’re not sure, it’s always best to check with their pediatrician.
What Happens if Your Child Is Constipated for a Long Time?
First, we consider “a long time” for constipation to be about three to six months. And what will happen if your child is constipated for that long is that their rectum will get backed up. Remember, the rectum sits with the bladder in that bowl of the pelvis, and those organs are supported by the pelvic floor muscles.
If the rectum becomes backed up, it can put pressure on the bladder and lead to urinary incontinence or nighttime wetting. Another thing that can happen is that the opening where the stool comes out can lose sensation, which means your child may not always get that urge or feeling that tells them they need to defecate.
When that happens, you might notice more of what we call bypass diarrhea or fecal smearing. This would be most obvious as staining in their underwear, if they are losing that urge and control over the anal opening.
How Pediatric Physical Therapy Can Help with Constipation
We want to make sure we address pediatric constipation early on to prevent these other problems from happening. At Metro Therapy, we’ll look at a few different areas, such as:
How are they breathing when they have a bowel movement?
Are they able to relax their pelvic floor muscles?
What does their diet look like?
Are they drinking enough water?
Are they eating lots of foods that can cause constipation like milk or cheese products?
Do they have their hips past 90 degrees on the toilet?
Do they have support under their feet on the toilet?
Are they holding their breath?
These things can all impact how easy your child’s bowel movements go. We especially want to make sure they are not holding their breath when they're having bowel movements because that puts more strain on the pelvic floor muscles and can actually make it harder to defecate. That’s why when I work with a child who has constipation, I have them make mooing noises while sitting on the toilet to keep the mouth open as they push because we don't want to put more strain on the pelvic floor and have them close it off instead of open.
Call Metro Therapy to Schedule a Consultation
If you think your kid has constipation, or if you’re concerned about any type of pelvic floor dysfunction, you can give us a call at (763) 415-7795 to make an appointment or ask questions and we are happy to get back to you.
