Constipation is one of the major reasons parents end up consulting with pediatric gastroenterologist Reema Gulati, MD. She sees this even when children have good diets and are physically active.

“There are many children whose parents are at a loss about what to do about constipation,’’ said Dr. Gulati, herself the mother of two younger children. “Parents are stressed about this and kids are stressed about this.’’

And stress, she says, is a mighty contributor to constipation.

“Pooping is an act of relaxing,’’ explained Dr. Gulati. “You shouldn’t have to push, and you need to give it some time.’’

And time is in short supply for many working parents, who rush to get everyone ready and out the door in the morning and rush to get dinner ready, baths done and children in bed at the end of the day.

“I don’t think there is a focus to poop regularly,’’ she said. If there isn’t time for this in the morning, Dr. Gulati suggests that parents encourage children after dinner to spend some time in the bathroom, perhaps with something to read or color, maybe a hand-held game.

The goal is to learn to relax.

“It may not work the first few times, but gradually children will get into a routine, their bodies will adapt and they will start getting into a rhythm of pooping,’’ she said.

The problem can be exacerbated during the school day.

“Kids don’t like using school bathrooms. They are afraid someone will look at them or tease them, or they don’t think the bathrooms are clean,” explained Dr. Gulati

The end result: some children hold their stool, which becomes harder, and colon is stretched more than it should be and, therefore, doesn’t work as well as it should.

Dr. Gulati also addressed recent questions about giving children polyethylene glycol 3350, an over-the-counter aid to help alleviate constipation by drawing water into the stool, thus making it easier to pass.

“I have it in my home and have used it with my children, but just having it shouldn’t be the end of the story,’’ she said.

Other tips for avoiding or alleviating constipation issues with children:

• Keep them active
• Make sure they drink plenty of water
• Encourage them to eat plenty of vegetables, fruit and whole grain foods with plenty of fiber

With eight out of 10 of her patients, when Dr. Gulati talks about constipation and children, “parents themselves realize they may have a constipation problem as well.’’

About the Expert

Reema Gulati, MD Division Director, Pediatric Gastroenterology Areas of Interest: Children with Gastrointestinal Diseases, like Crohn's Disease, Ulcerative Colitis, GERD, Chronic Constipation, Encopresis, Chronic Abdominal Pain, Gastroesophageal Reflux Disease, Eosinophilic Esophagitis, Swallowing Problems/ Dysphagia, Chronic Diarrhea and others Learn more about Dr. Reema Gulati