My two-year-old is so constipated. What are suppositories and are they a good idea?
To best answer your question I turned to the SickKids Constipation Working Group. First, let me tell you this question is quite common. It’s important to understand what we mean by the term “constipation”. While most people think it only applies to the frequency of the bowel movement, it also can mean the stools are harder in consistency, and cause pain during a bowel movement.
Before you consider a suppository, let’s figure out what might be contributing to the problem. Look at what your child is eating and determine if your child is getting enough fluid and fibre from cereals, fruits and vegetables. There could also be a behavioural cause. Sometimes children actually hold their stools in. Some don’t like to use public bathrooms and prefer to go at home. Others may have problems around toilet training.
First try to treat this with diet and lifestyle changes rather than medication, though it might take some time to change the pattern that is now established. In this age group, children often don’t drink enough water. Remember that Canada’s Food Guide calls for four to six servings of fruits and vegetables a day and that indeed can be a challenge! Read labels to see how much fibre is in the cereals or breads you are buying and aim for about seven grams or so in this age group. Older children typically require more fibre. Try high fibre breads and make your own bran muffins.
According to SickKids, the most effective medications for constipation are stool softeners such as lactulose, sorbitol or, most commonly, polyethylene glycol (PEG 3350).
My advice is to avoid suppositories in favour of this approach. As always, see your doctor to discuss specific management. There are certain red flags that might prompt more investigation to tease out the cause of constipation such as blood in the stool or fever.
Dr. Marla Shapiro is a medical doctor, author, broadcaster, lecturer and parent.
Originally published in ParentsCanada magazine, February 2014.