Exercise

Encopresis, Exercise and COVID-19

Encopresis could be an unfortunate consequence of community efforts to control the spread of COVID-19 due to decreased opportunities for outdoor exercise. Children who are physically active are less likely to become constipated than those who are not. Unfortunately, school closures and stay-at-home orders combined with the closure of parks and playgrounds in some communities severely limit opportunities for physical activity. Forced to stay inside, children will also be spending more time than usual in front of "screens" which we know causes many children to ignore bowel urgency which can lead to constipation.

Parents need to encourage their children to walk, run and ride bikes and scooters etc as much as possible even if it's just up and down the street in front of their home while making sure that they maintain the "6-foot rule". 


Encopresis Treatment and Exercise

Parents of young children being treated for encopresis sometimes think it strange that their child likes to runs around before pooping. One parent said, "My son often needs to run up and down the hallways to make a bowel movement." In fact, there is nothing strange or unusual about this at all. As I say in my book, The Ins and Outs of Poop:

"Exercise is important (especially when treating encopresis!) because it directly affects the movement of stool. Our large intestine works better when we are active. Children (and adults) frequently experience the urge to poop either during exercise or shortly thereafter. Children who are physically active are less likely to become constipated than those who are not." (page 50)

Exercise helps constipation by decreasing the time it takes food to move through the large intestine thereby decreasing the amount of water the large intestine absorbs from stool. Aerobic exercise, like running, is especially helpful because, by speeding up breathing and heart rate, it helps stimulate intestinal peristalsis.

Therefore, provided that your child's laxative and liquid intake is sufficient to make his stool softer than normal ( applesauce or pudding), you might want to encourage your child to run around for a few minutes before sitting to try to poop. 

 

 

Travelling and constipation

I was recently asked for advice or "tips" about how to prevent constipation when travelling with children.


It is fairly common for young children to become constipated when their normal eating and sleeping schedules are disrupted.

For example, a number of parents have told me that their child first became constipated while driving between Seattle and California to visit Disneyland, in some cases necessitating an ER visit along the way. Vacation trips are especially difficult for kids because of having to eat at different times and in different surroundings. Kids also become constipated when travelling because of dehydration and insufficient exercise.

To prevent constipation while traveling, I recommend that...

...parents do the best they can to maintain their child's usual eating, nap and bed times and to be sure that their child drinks extra fluids and gets plenty of exercise.

As I say in my book, The Ins and Outs of Poop, our GI tract "likes" exercise: exercise helps us poop. So, if driving a long distance, make frequent stops to let your child walk or run around a bit before sitting on the potty. If you're in an airplane, use the times when the food and beverage carts are not in the way to walk your child up and down the aisle a few times.

PS. All of these recommendations for avoiding constipation apply to adults as well!


Squatty Potty and Functional Constipation or Encopresis

The Squatty Potty is a footstool for children and adults which elevates your feet while sitting on the toilet. The footstool changes your posture so as to more closely approximate squatting than sitting. It comes in both 7" and 9" tall versions.

Squatting is thought by many GI doctors to be the most natural and efficacious position for defecation. I agree. In the squat position, the angle between the rectum and the anal canal is wider/straighter than it is in the sitting position thus allowing stool to pass through with less effort/straining.

How does this relate to functional constipation/encopresis)?

In my book, The Ins and Outs of Poop, I talk about how one or more uncomfortable or painful bowel movements can cause a child to begin to withhold stool whenever she or he feels urgency so as to avoid another uncomfortable or painful bowel movement. Unfortunately, withholding can become a conditioned or habitual response to the feeling of urgency which almost inevitably leads to functional constipation aka encopresis. 

The key to preventing functional constipation is to act quickly with natural remedies when your child has occasional constipation in order to keep his or her stool soft and the need for pushing/straining at a minimum.

In my opinion, the use of a higher than normal footstool such as a Squatty Potty should be thought of as one of the natural remedies for occasional constipation along with more common remedies such as increased fiber and exercise. Footstools like the Squatty Potty may also be of help in the long-term treatment of encopresis.