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Constipation in Children: A Guide for Parents

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What is it?

Constipation is a common issue in children characterised by infrequent bowel movements or difficulty passing poo. It occurs when poo become hard, dry, and difficult to pass, leading to discomfort and straining during bowel movements.

Constipation can be caused by various factors, including diet, dehydration, lack of physical activity, or underlying medical conditions.

What symptoms do you get?

Symptoms of constipation in children may vary but often include infrequent bowel movements, difficulty passing poo, abdominal pain or cramping, bloating, and sometimes small, hard poo that may be painful to pass. Children may be reluctant to use the bathroom due to discomfort or fear of pain.

Sometimes children can develop ‘overflow diarrhoea’ which is loose and smelly. This occurs when there is a large amount of hard poo in the bowel which causes fluid to build up behind it, eventually leaking out and causing diarrhoea.

How is it diagnosed?

Constipation is usually diagnosed based on the child’s symptoms and medical history, along with a physical examination by a healthcare professional. Your healthcare provider may ask about your child’s bowel habits, diet, fluid intake, and any recent changes in behaviour or routine. In some cases, additional tests may be done in order to rule out underlying medical conditions or complications.

It might be useful to keep a diary of your child’s bowel movements. The below linked ERIC website has an excellent poo diary.

What is the treatment?

Treatment for constipation in children typically focuses on relieving symptoms and promoting regular bowel movements. This may include dietary changes such as increasing fibre intake by offering more fruits, vegetables, whole grains, and legumes, as well as encouraging plenty of fluids to prevent dehydration. If your child is a fussy eater, have a look here for helpful tips. Regular physical activity can also help stimulate bowel movements and promote digestive health. In many cases, your healthcare provider may recommend laxatives or poo softeners to help soften poo and ease passage. Additionally, establishing a regular bathroom routine and encouraging your child to use the bathroom when they feel the urge can help prevent constipation from recurring.

Remember, while occasional constipation is common and usually resolves with simple lifestyle changes, persistent or severe constipation may require further evaluation and management by a healthcare professional.

Henoch-Schönlein Purpura (HSP), or IgA Vasculitis, in Children: A Guide for Parents

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Henoch-Schönlein Purpura (HSP), now known as IgA vasculitis, is a type of inflammatory condition known as vasculitis, that affects the small blood vessels in the skin, joints, intestines, and kidneys. It is one of the most common types of vasculitis in children and typically occurs between the ages of 2 and 11 years old. While the exact cause of HSP is unknown, it is believed to be related to an abnormal immune system response, often triggered by a preceding infection.

What symptoms do you get?

Symptoms of HSP can vary but often include:

  • Purpura: Small, raised purple or red spots on the skin, typically on the legs and buttocks, which may be painful or itchy.
  • Joint pain and swelling, particularly in the knees and ankles.
  • Abdominal pain or cramping.
  • Nausea, vomiting, or bloody stools.
  • Kidney involvement, which may lead to blood or protein in the urine, decreased urine output, or high blood pressure.

It’s essential to seek medical advice if your child develops any of these symptoms, especially if they occur suddenly or worsen over time.

How is it diagnosed?

Diagnosing HSP in children usually involves a combination of a physical examination, medical history, and blood and urine tests. Blood tests are done to check for signs of inflammation and to assess kidney function, while urine is tested for blood and protein. Your child’s blood pressure will also be taken.

What is the treatment?

In most cases, HSP resolves on its own within a few weeks to months without specific treatment. However, symptomatic relief may be provided with over-the-counter pain relievers such as paracetamol to alleviate joint pain and discomfort. It’s essential to follow your healthcare provider’s advice closely and attend regular follow-up appointments to monitor your child’s progress as about half of children with HSP will have a further episode. Typically, your child will be followed up at regular intervals for one year.

Rarely, in more severe cases your child may require additional treatments such as medicines to reduce inflammation and protect organ function.

Most cases of HSP will be monitored and resolve without long-term complications. If you have any concerns about your child’s health or if their symptoms are severe or worsening, seek medical advice promptly.

Urinary Tract Infections in Children: A Guide for Parents

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A urinary tract infection (UTI) occurs when bacteria enter the urinary tract and cause infection. UTIs are common in children and can occur at any age, although they are more common in girls than boys.

What symptoms do you get?

Symptoms of a UTI in children may vary depending on the age and severity of the infection but often include:

  • Pain or burning sensation during urination.
  • Frequent urination or urgency to urinate.
  • Foul-smelling or cloudy urine.
  • Blood in the urine.
  • Abdominal pain or back pain.
  • Fever.
  • Irritability, fussiness or vomiting in infants.
  • Bedwetting or accidents in toilet-trained children.

It’s essential to pay attention to any changes in your child’s urinary habits or behaviour and seek medical advice if you suspect a UTI.

How is it diagnosed?

Diagnosing a UTI in children usually involves a combination of a physical examination and testing the urine. Your child’s healthcare provider may ask about their symptoms, medical history, and any recent illnesses. In some cases, imaging scans may be done to assess the urinary tract for structural abnormalities or other underlying conditions.

What is the treatment?

Treatment for UTIs in children typically involves antibiotics to eradicate the infection and relieve symptoms. The type of antibiotic prescribed will depend on the child’s age, the severity of the infection, and any underlying health conditions. It’s essential to complete the full course of antibiotics, even if your child’s symptoms improve before the medication is finished. In addition to antibiotics, your child may also be encouraged to drink plenty of fluids to help flush out the bacteria and relieve discomfort.

Remember, prompt diagnosis and treatment of UTIs in children are crucial to prevent complications and promote recovery. Some children will be referred to the RHCYP Urinary Tract Infection clinic for follow up and further scans after a urinary tract infection.

How can I prevent urinary tract infections?

There are some simple things you can do to prevent UTIs in infants and children at home.

  • Make sure your child has a good fluid intake, spread evenly through the day.
  • Make sure your child is not constipated -this is one of the commonest causes of UTI. If your child poos less often than every 2 days, or poos are hard, painful or large, discuss with your doctor to consider constipation and treatment for this.
  • Encourage your child to pass urine regularly throughout the day, every few hours, or if in nappies, change nappies regularly.
  • Make sure girls are wiping after passing urine or stool from ‘front to back’.
  • Have regular baths or showers, using plain soap to wash, avoiding bubble baths.

Viral Gastroenteritis: A Guide for Parents

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What is it?

Viral gastroenteritis, often referred to as a stomach bug, is an infection of the intestines caused by various viruses, such as norovirus, rotavirus, or adenovirus. It is highly contagious and can spread easily. Viral gastroenteritis is a common illness, particularly in children.

What symptoms do you get?

The symptoms of viral gastroenteritis usually include sudden onset of diarrhoea, which may be watery or contain mucus, as well as vomiting, stomach cramps, nausea, and sometimes fever. The usual duration of diarrhoea is 5-7 days and in most children it stops within 2 weeks. The usual duration of vomiting is 1-2 days and in most children it stops within 3 days.

How is it diagnosed?

Viral gastroenteritis is typically diagnosed based on the child’s symptoms and a physical examination by a healthcare professional. In most cases, specific tests to identify the virus causing the infection are not necessary, as the illness is usually self-limiting and resolves on its own without specific treatment. However, in severe cases or if complications are suspected, your healthcare provider may recommend stool tests or other diagnostic tests to rule out other possible causes of the symptoms.

What is the treatment?

Treatment for viral gastroenteritis focuses on relieving symptoms and preventing dehydration. ‘It’s essential to keep your child well-hydrated by offering frequent sips of sugary fluids, avoiding fizzy drinks. You can also consider oral rehydration solutions, such as dioralyte, which is available in supermarkets and chemists. You can also offer bland, easy-to-digest foods such as crackers, rice, bananas, and toast as tolerated. In some cases, your healthcare provider may recommend anti-nausea medications, but these are typically reserved for more severe cases or for children at higher risk of dehydration. To help prevent the spread, wash your hands with soap and water regularly, especially after going to the toilet, changing a nappy or before touching food. Your child should stay off nursery/school until 48 hours after vomiting and diarrhoea.

Remember, viral gastroenteritis is usually a self-limiting illness that resolves on its own within a few days to a week with proper care and hydration. However, it’s important to monitor your child closely for signs of dehydration, such as decreased urine output, dry mouth, or lethargy, and seek medical advice if you have any concerns.

Use this quick guide to know what signs to look out for in your child.

Contact NHS Lothian