Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
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Monroe Carell Jr.
Children's Hospital
at Vanderbilt
2200 Children's Way
Nashville, TN 37232


(615) 936-1000

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Additional Testing and Treatment

 

Additional testing

In most cases of constipation, diagnosis is based on the child's medical history and physical examination. We sometimes use abdominal X-rays to assess whether significant fecal retention is present. Other tests, such as the following, may be ordered if an organic cause is suspected.

  • Laboratory evaluation
  • Contrast enema (Barium enema)
  • Anorectal manometry
  • MRI of the lower spine
  • Rectal biopsy
  • Sitz marker colonic transit study

Treatment

At Monroe Carell Jr. Children's Hospital at Vanderbilt, we use a comprehensive approach to treatment including medical therapy, behavioral modifications, and dietary interventions. Treatments for constipation can include:

  • A cleanout or bowel evacuation
  • Daily maintenance medication to soften the stool to help it slide out more easily while reducing pain
  • Frequent toileting or frequent attempts to have a bowel movement. A constipated child with a full rectum cannot feel the urge to have a bowel movement, thus we have to remind them to try. Since an internal reflex signals the colon to empty when the stomach is full, we try to take advantage of this and toilet 30 minutes after meals for best results. To help them push harder when trying to have a bowel movement, rest the child's feet on a small step stool on the floor.
  • High fiber diet with plenty of water. Help your children get the fiber they need
  • Most children benefit from praise and/or rewards for sitting on the toilet and attempting to have a bowel movement. Some children enjoy reward or sticker charts to monitor progress. Bowel Movement Progress Chart
  • Referrals to see the registered dietician or child psychologist, if needed

Together, these steps help to keep the colon and rectum emptied so the rectum can return to its normal size and function properly.

Expected results of this treatment program are

  • A ceasing of soiling accidents
  • The child becomes accustomed to more regular, comfortable bowel movements
  • Considerable stool softening
  • Reduction of pain when passing stool
  • Familiarizing the child the normal body functions

Duration of treatment

By the time our treatment program is started, many children may have had constipation for months or years. As a result, it sometimes takes weeks to months to see improvement. The bowel treatment program is generally continued for a minimum of six months.


Last Edited: January 16, 2017
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