Children

Meet the Constipation Team

Our Primary Care nurses provide support to families and young people on constipation.

 

What do we do?

Here at the Children and Young People's Health Partnership (CYPHP), our specialist children's constipation nurses work with a children's pharmacist and emotional wellbeing professionals to make sure we are looking after your child and family as best we can. Emotional and behavioural issues are understandably common in children and young people with long-term or chronic conditions – no CYP wants to be "ill" or "different" in a way they don't choose. At CYPHP we're here to help you and your family with all that concerns you and your child.

We can see you at your home or at a nearby clinic, and we make sure other healthcare professionals, who are involved in your child's care, know what's going on.

We have just started so cannot yet offer our service to children across all of Lambeth and Southwark, but please do speak to your hospital doctor about us if you think you and your child could benefit from our service.

Check out our frequently asked questions section below too:

Q1. What is Constipation?

Constipation is the most common bowel problem in children. It is the inability to do a poo regularly or to completely empty the bowel. Constipation is the most common bowel problem in children. It can start at any age (including babies) and affects up to 30% of all children.

It is helpful to understand how the bowel works to explain constipation. 

Food is chewed, swallowed, and mashed up in the stomach to a smooth mixture. It heads into the small bowel where all the nutrients are absorbed into the body. It then moves into and through the large bowel. The large bowel pushes it along and absorbs water along the way leaving a soft sausage shaped poo which sits in the rectum, causing a signal to be sent to the brain saying the child needs a poo. 

A child who has a healthy bowel will pass soft poo regularly (at least 4 times a week) without any pain or discomfort. The longer the poo sits in the rectum, the more water is drawn out of it, causing it to become harder. The body stops send the signal to the brain so the child may not realise they need a poo. 

Liquid poo can seep around this hard lump and leak out the child’s bottom so may look like diarrhoea.

 Bristol Stool Chart

Fun Stuff

https://www.eric.org.uk/poo-and-wee

https://www.eric.org.uk/fun-stuff 

Poo Game

http://letstalkaboutpoo.eric.org.uk/

Pirate Pete and the fearsome skids

https://www.eric.org.uk/Handlers/Download.ashx?IDMF=9835e245-5930-4213-96b8-cd5eacff6b62

Videos

https://www.eric.org.uk/videos-about-wee-and-poo

Q2. How does Constipation affect children and families?

There can be problems with embarrassment amongst peers, low mood, need for a healthier diet and lifestyle than family can manage.

Q3. What are the signs of Constipation?

The child maybe avoiding going to the toilet due to previous painful experience, a sore bottom, or unfamiliar toilets. Signs include:

  • Pooing less than four times a week
  • Regular and foul-smelling wind.
  • Foul-smelling poo.
  • A painful tummy.
  • A distended (ie swollen or bloated) tummy.
  • Poo that looks like hard pellets.
  • Poor appetite.
  • Lack of energy.
  • Unhappy, angry, or irritable mood.

Q4. What are the causes of constipation?

Idiopathic Constipation

For most children there is no underlying condition or reason for their constipation. There are many reasons why idiopathic constipation may develop. Here are some common reasons:

  • Withholding poo (also called ‘stool withholding’, which is when a child avoids emptying their bowels).
  • Fear of the toilet (sometimes associated with pain or discomfort).
  • Lack of a toilet routine (some children have such busy lives that it can be difficult to find time to sit and relax on the toilet each day).
  • Resistance to potty training and an insistence that a nappy be put on to poo in.
  • An unbalanced diet.
  • Low fluid intake.
  • A change in routine.
  • Anxiety and emotional upset (for example when starting nursery or potty training).
  • Some medications.

Q5. What should I do if I'm also worried about my child's emotional wellbeing, mood or behaviour?

 It's always ok to ask for help if you are worried about your child's moods or behaviour.  It may seem like a silly thing to say but sometimes it can be hard to start a conversation with your child about how they are feeling.

You might be worried because you have only seen them act aggressively when playing with their toys or because you don't think they can really understand what death of a close family member means. You might be worried about making whatever is bothering them worse by asking them about it – it won't  - the most important thing is to start talking with your child so that they can get the help they need.

If you are struggling with how to start the conversation you can contact the YoungMinds Parent's Helpline with any question:  https://youngminds.org.uk/find-help/for-parents/parents-helpline/

Trying once is often not enough to get to the bottom of things, so if you've tried several times and your child still isn't opening up, try talking to their teachers or close fmaily members to see if they can shed any light.

If you have been worried about them for some time and feel like you are not getting anywhere, make an appointment to see your GP.

Q6. What should I do if I'm also worried about my teenager's emotional wellbeing, mood or behaviour?

Getting teenagers to talk openly about what is bothering them can be particularly difficult. Try using some of the tips contained here to start the conversation: http://www.nhs.uk/livewell/mentalhealth/pages/talkingtoteens.aspx or go to the Young Minds parents helpline for advice, https://youngminds.org.uk/find-help/for-parents/parents-helpline/

Often teenagers do not want to speak to people "in authority", i.e. people like parents or teachers. Urge them in that case to speak to their siblings, friends or a counsellor through Childline, https://www.childline.org.uk/get-support/

Q7. How can I talk to my healthcare professional about my emotions or concerns for my child?

It can be really difficult to talk to your doctor about your mental health or concerns about your child's mental health. There is no right or wrong way but you have to make that first step to get the help you need. It can be really difficult to talk to your doctor about your mental health or concerns about your child's mental health. There is no right or wrong way but you have to make that first step to get the help you need.

Think about:

  • Being as open and honest as you possibly can. This might be difficult the first time around especially if you don't know your doctor very well but say what you can. This video from the charity Mind has some useful tips on how to prepare: https://youtu.be/Dqb-n_L5hIA
  • Remember that your doctor has been trained to listen to very sad or difficult things that have happened to you or your child and are there to help you work through how they are making you feel or behave.
  • Focus on how you feel and responding to questions they ask you honestly.
  • Don't worry if you don't really know what the problem is or that it might not seem important enough – your doctor is there to help you with emotional problems every bit as they are there to help you with physical problems.

Emergency Numbers

Physical Health

If you are in danger, a lot of pain or you are concerned about an immediate risk of harm - either to yourself or someone else, dial 999.

If you need urgent medical help or advice - but it is not life threatening - call 111

Mental Health

If you need to talk to someone urgently, call Child Line on 0800 111 or the Samaritans on 08457 909090.

If you, a family member or friend are in distress and need urgent help, contact South London and Maudsley Hospital's 24-hour mental health support line on 0800 731 2864.

If you feel unsafe and need immediate help, go to your nearest hospital with an Accident and Emergency (A&E) Department - where the psychiatric liaison team can help you (24 hours a day, 365 days of the year).

Your GP

If you need help but you can wait until the next day then please visit your GP as the first point of contact.

 

All the numbers and services above are free and confidential.

This is not an emergency service, please contact 999 if someone is seriously ill and their life is at risk