Fiber, Liquid and Encopresis

One of the most common misconceptions about encopresis (functional constipation) even among healthcare specialists, is that it is caused by not eating enough fiber and/or not drinking enough liquid. The truth is that diets low in dietary fiber or liquid do not cause functional constipation. Functional constipation (encopresis) is caused by stool withholding and subsequent rectal distention. However, for prevention, fiber-rich diets are recommended for all children, especially for those who have a history of occasional or functional constipation.

Dietary sources of fiber contain both soluble and and insoluble fiber (see Chapter 17 in my book for the important differences between the two.) For children, the daily amount of fiber recommended is the age of the child plus five grams.  The recommended liquid consumption from all sources for children 1-8 years of age is 4 to 5 cups (32 to 40 fluid ounces) a day.


3 y/o Refuses Laxatives: Sneaky Chef Helps

The mother of a 3 year old girl, whose painful episodes of constipation began when she was 11 months old, recently told me that her daughter was now refusing to ingest any laxative in ANY form, even though laxatives had previously made her bowel movements soft and painless. No matter how we tried to disguise Miralax in countless liquids or Ex-Lax (chocolate form), even in foods like chocolate chip cookies, she refused them.

While working on this problem, we decided to increase the fiber in her diet (obviously she was a picky eater generally, so this, too, was difficult!) and came upon some really wonderful books by Missy Chase Lapine such as The Sneaky Chef: Simple Strategies for Hiding Healthy Foods in Kids' Favorite Meals.

Increasing dietary fiber was helpful for this girl but, as I explain in my book, fiber is much more important and effective for preventing serious constipation than it is for treating it.  Keeping stool soft and bowel movements frequent for extended periods is typically only accomplished via laxatives.

Encopresis and Diet

Parents frequently ask if their child's encopresis (functional constipation) was caused by their diet . They also want to know if there is a particular diet that will cure their child's encopresis.

The answer to both questions is that diet alone does not cause encopresis nor is there a particular diet that will cure encopresis. However, there are certain foods that if consumed regularly can help to prevent encopresis and, in combination with laxatives and certain behavioral interventions, can help to cure encopresis.

Food which are high in both soluble and insoluble fiber are the most helpful. Dietary fiber, which includes both soluble and insoluble, is defined as indigestible carbohydrates found in plant cell walls. Some foods are higher in soluble fiber (such as oats and peas) while other foods are higher in insoluble fiber (such as vegetables and whole grain bread).

More detailed information about the amount fiber in specific foods, the daily fiber requirements for children and about different fiber supplements can be found in chapter 17 (Food and Drink for Good Poops) of my book.