Did You Know Fecal Impaction is Common in Children Too?

Fecal impaction refers to a condition where hard to stony hard fecal mass gets stuck in the lower large bowel to rectum prohibiting the ability to fully emptying of bowels leading to frustration and other issues affecting their daily life. Should the impaction last a prolonged period, it can lead to a build-up of fecal matter that is added to with each meal, making it harder and more difficult to pass, ultimately causing a complete blockage of the bowels, which can be extremely dangerous. 

• Taking large bites of food but not chewing them properly, so that the food cannot be easily digested. 
• A diet low in fiber, leading to hardened stools that are difficult to pass. 
• A potential bacterial or parasitic infection, which can cause absorption irregularities to affect the bowels. 
• Children not passing stools between the hours of 05:00 – 07:00 a.m., which is the best time for bowel movements. 
• Childhood abdominal surgeries can cause a membrane to form around the colon that causes a slow motility due to which fecal matter can build up. 
• Children holding in bowel movements due to fears of using the toilet, which may be due to anal fissures or rectal wound that causes pain during bowel movements.  
• Children with chronic constipation may experience a stretching, swelling, and elongation of the bowels. If this occur, the fecal mass may remain in the folds of the bowel causing bowel cramping. 

As the fecal impaction deteriorates, fecal matter begins to accumulate in the child’s bowels, placing pressure on the stomach and bladder, which can cause a wide range of symptoms, such as: 

• Stomach pain resulting from indigestion or prolonged bouts of constipation 
• Passing bloody stools 
• Fecal incontinence or fecal soiling 
• Aches and pains affecting certain parts of the child’s body, such as the back, legs, shoulders, or neck 
• Dizziness, fatigue, vomiting, or a loss of appetite 
• Feeling so irritated that they find it hard to sleep or lack quality sleep 
• Frequent urination alongside bladder inflammation, eventually resulting in pyelitis 

• Try to get your child into a bathroom routine, including using the bathroom or sitting on the toilet between the hours of 05:00–07:00 each morning. However, parents must be careful that their child does not feel threatened or afraid of using the bathroom due to external pressures. 
• Ensure your child eats a high fiber diet, including various fruits and vegetables. 
• Make sure your child drinks enough milk, liquid nutrition, and other liquids as this will soften stools. 
• Encourage your child not to hold in bowel movements, instead using the bathroom as soon as the urge develops. 
• Provide your child with yogurts or probiotic drinks to help them maintain a healthy gut microbiota, where soft stools are produced. 
• Teach your child to engage in light activity following meals to encourage intestinal function that will also ease bowel movements. 
• Should your child experience any bowel issues, you may want to increase their intake of certain foods or drinks, such as milk, yogurt, sour fruits, prunes, orange juice, or lemon juice. 

Parents may conduct basic screening for fecal impaction in their child by running a finger along the left side of the child’s abdomen, underneath the naval, to seek out a lump. You should feel a long, sausage-like organ that moves when pushed. If parents cannot detect the organ despite applying a gentle pressure to the area, they can ask the child to lay on their side while breathing in to pull in their stomach. The intestines of thinner children will be easier to locate than those of their overweight counterparts. 

However, if parents notice their child is experiencing any of the following symptoms, they should be taken to undergo gastrointestinal screening: stomach pain, being irritable for no apparent reason, bloating and indigestion, or passing bloody stools. Said screening will include; 

• Inquiries into their medical history 
• Stool analysis 
• Digital rectal examination 

Alternatively, where other conditions are suspected, doctors may request that the child undergo an endoscopic assessment, which involves a long tube with a tiny camera on the end being inserted into the child’s digestive system via their mouth or rectum. Endoscopic assessments are classified into upper GI endoscopies that analyze the esophagus, stomach, and small intestines, taking approximately 10 minutes to complete, and colonoscopies that analyze the lower GI system, including the caecum, colon, large intestine, and rectum, and which take approximately 30–60 minutes to complete. Alternatively, medical staff may utilize a video capsule endoscopy technique to analyze the small bowel. Although this takes around 8–12 hours to complete, it can provide a clear pathological picture of the entire digestive system. 

Such screening techniques must be carefully customized to meet the specific needs of pediatric patients, who are placed under sedation or general anesthesia to reduce anxiety and pain. Fortunately, these techniques are hugely effective in the diagnosis of said conditions, enabling targeted treatment to take place thereafter. 

Issues associated with the bowel movements of children should never be ignored due to the potential impacts they can have throughout the child’s body. Hence, a doctor’s appointment is highly recommended should your child experience any of the following symptoms: stomach pain, indigestion, bloating, chronic constipation, bloody stools, constant crying, vomiting, and insomnia. Do not, under any circumstances, purchase over-the-counter medication as doing so could be dangerous. Doctors are always best placed to perform diagnoses and provide targeted treatment for your child’s illness. 

Learn more here about our services at PEDIATRIC GASTROINTESTINAL AND LIVER CENTER 

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