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  1. Education
  2. Childhood constipation
  3. Childhood constipation
Practice 10-Minute Consultation

Childhood constipation

BMJ 2021; 375 doi: https://doi.org/10.1136/bmj-2021-065046 (Published 02 December 2021) Cite this as: BMJ 2021;375:e065046

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Re: Childhood constipation

Dear Editor

The 10 minute consultation on childhood constipation (Bradshaw et al, 11th December) focuses almost entirely on medical management with scant discussion about diet and lifestyle. Whilst not denying that effective management of an established idiopathic constipation problem requires effective and diligent use of laxatives, we believe that with the growing incidence of constipation there is a pressing need to educate both the parents and medical staff about the significance of diet and lifestyle intervention. Evidence gathered from around the world(1,2,3) shows that dietary fibre intake is poor in most children but is worse in those with constipation.

The medicalisation of a problem which is essentially the consequences of poor diet and lifestyle further highlights the lack of adequate nutritional education for doctors and other health care practitioners. It is not enough to simply make dietary recommendations to parents about eating more fibre but this should be followed up with counselling, ongoing support and education(4,5).

References :
1. Ip KS, Lee WT, Chan JS, Young BW. A community-based study of the prevalence of constipation in young children and the role of dietary fibre. Hong Kong Med J. 2005 Dec;11(6):431-6.
2. Inan, M., Aydiner, C., Tokuc, B., Aksu, B., Ayvaz, S., Ayhan, S., Ceylan, T. and Basaran, U., 2007. Factors associated with childhood constipation. Journal of Paediatrics and Child Health, 43(10), pp.700-706.
3. Macêdo, M., Albuquerque, M., Tahan, S. and Morais, M., 2020. Is there any association between overweight, physical activity, fat and fiber intake with functional constipation in adolescents?. Scandinavian Journal of Gastroenterology, 55(4), pp.414-420.
4. Karagiozoglou-Lampoudi T, Daskalou E, Agakidis C, Savvidou A, Apostolou A, Vlahavas G. Personalized diet management can optimize compliance to a high-fiber, high-water diet in children with refractory functional constipation. J Acad Nutr Diet. 2012 May;112(5):725-9. doi: 10.1016/j.jand.2012.01.021. Epub 2012 Apr 25
5. McClung HJ, Boyne L, Heitlinger L. Constipation and dietary fiber intake in children. Pediatrics. 1995 Nov;96(5 Pt 2):999-1000.

Competing interests: No competing interests

19 December 2021
Samantha. J Robson
Medical director
Temple clinic
Aberdeen, Scotland

Re: Childhood constipation

Dear Editor
Useful article thanks on treating this very common condition, however it did not emphasise the elephant in the room that this is a western country condition mainly caused by a poor diet, high in processed foods and animal products and low on plant origin foods - whole grains legumes fruit and vegetables- as recovered by public health guidelines. This condition is taste In countries whose diets consist of these foods.
The condition is a red flag that the food intake is wrong and will cause far more serious conditions as the child grows up, leading to the chronic diseases that kill most of our western population prematurely.
Thanks for emphasising this crucial point about the condition in future. Good health for love starts with good childhood eating habits.

Competing interests: No competing interests

10 December 2021
Mark f Craig
True south Medical
Mt albert Auckland nz
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