Constipation: Causes and Cures

Unfortunately, constipation is no laughing matter and it has caused me no end of worry. (Hence the lovely text messages to my hubby while he's at work.) For some reason, I gauge my success as a mom on the details of his BMs! But, now that Jett's 2 years old, I've finally figured it out! He goes every single day with no pain and perfect color and consistency. (I'll spare you the details!) So please allow me to share what I've found so you can get this problem solved more quickly... But, first:

WARNING: DO NOT USE MIRALAX. I realize that your doctor probably has recommend this for your child but, Miralax has never been approved for children and Miralax causes damage. Please read The Role of Miralax in Autism, Alzheimer's and Dementia. And Miralax's connection to “neuropsychiatric events.”

Safe Solution Summary

#1 treatment: Get your child's thyroid tested and properly treated. In the meantime...

For babies: consider trying Digestion Support Herbal Oil from Heritage Essential Herbs. It seems expensive, but not when you think about how long it lasts and, more importantly--it works! I simply rubbed a couple of drops on his stomach in a clockwise motion around his belly button at least three times a day (easy to do after diaper changes).  

Immediate Solution: buffered Vitamin C (to bowel tolerance) and/or Magnesium (also to bowel tolerance). Click the links to see how to use it and what the recommended brands are. Works great every time! Jett takes both everyday.

Long Term Solution: I also give Jett probiotics and enzymes as the long-term solution to constipation since it helps the gut to heal itself and support his body so that he will be able to properly metabolize and dispose of the food he eats. (If I haven't posted on enzymes yet, please email me and I will send you my post draft explaining it.) Treating the thyroid, however, is the number one long-term solution.

Constipation is such a common problem with our kids for many reasons. Two Moms, Ali and Jayme, share their research and strategies in order to help us all out.

Why do our children have trouble with constipation?

First, constipation is a red flag for hypothyroidism, Celiac Disease, Hirschsprung and other digestive disorders. Please read this post on the thyroid and DS. Make sure your child is properly screened to rule those out or to get them treated as soon as possible. Otherwise, (and less likely,) constipation could be from dehydration, low physical activity, or diet (avoiding grains and dairy usually helps). Many people have seen some success by following a healthy diet plan like www.gapsdiet.com or similar. Sometimes just making sure probiotics are part of your plan will fix it in the long run.

"The direct cause of constipation is not enough water in the stool. This occurs because of the diet not having enough water-retaining elements (fiber) or because the stool is kept in the rectum too long, allowing the colon to reabsorb more water than usual. In children with Down syndrome, two factors exist to make constipation more likely: low muscle tone and decreased motor activity. Both of these make the colon more likely to retain stool for longer periods, leading to loss of water from the stool." --from Dr. Leshin's page on constipation at http://www.ds-health.com/constip.htm

But I think that low serotonin could also be a factor... Serotonin is found throughout the body, especially in the gut. That's why people with DS who go on Prozac usually become regular. (But then the constipation eventually comes back... long story... but it's because the serotonin is recycled instead of regenerated on Prozac and eventually kind of runs out.) People with DS frequently show low serum tryptophan levels (a precursor to serotonin). And 100% of kids w/DS in a study (see below) had levels of serotonin that were only 40% of what is typical.

Serotonin can be increased with 5-Hydroxytryptophan, (5HTP) the precursor to serotonin. It's a good one to consider especially given its low rate of adverse effects compared with selective serotonin reuptake inhibitors (SSRIs), better known to us as antidepressants, such as Prozac. However, a 1971 study³⁴ found that giving 5-HTP may cause spasms in infants. The dosage that led to these symptoms was 1.0 to 1.4 mg/kg in an infant aged 6 to 8 weeks. The patient did well once the dosage was adjusted. Tryptophan is also helpful, but takes about 3 months to fully restore levels, as well as B6 (not good to give large amounts of this to people with DS, but a little is okay) and niacin. I give Jett tryptophan and a little B6.

Here's a study about DS and serotonin: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1762754/?page=2

A good book to show how to restore levels of serotonin naturally: The Mood Cure. (I am implementing her recommendations for Jett, my husband and myself.)

Also, if your child is constipated, the actual act may be very painful and unpleasant so he may end up holding it in when he does feel the urge. Of course, that only makes the problem worse.

Ali shares: 

We did go to a GI doc and he couldn't figure out a reason for our son's constipation. We found some supplements that work for him at the present. Others find success in higher doses of probiotics or with hefty doses of certain food items or with a combo of supplements, massage and pushing fluids. I think it can really vary from child to child.

Infant fleets or an oil enema

Once we realized it wasn't a good idea allow him to retain the poop, we made sure that Jack went daily -- with our help -- until we found our answer. [You don't want to wait longer than 3 days-Andi.] An olive oil enema to us was simply taking an empty bottle of this type http://www.walgreens.com/store/c/fleet-pedia-lax-for-ages-2-11-years-saline-laxative-enema/ID=prod3946475-product and filling it with olive oil... warming it a bit by setting it in hot water in a container... but not too warm... then in the most relaxed atmosphere we can create... pillows around, everything we need handy... maybe a favorite show or music on .... we'd use a bit of the oil as lubricant and then you insert gently and go slow keeping the bottle tipped so that you're not putting air in there. Once it's emptied as best you can you put on a diaper and wait. They can just play or whatever... we usually had success withing 10-15 mins.. Occasionally we had to do it again... but that was rare. The only thing we might change if we had to do an oil enema now is that I might try flax oil instead.... it's high in omega-3's and olive oil isn't.

What works with Ali's Jack

First I'll say what didn't work... massage, Fruit EZE, prunes, flax, cranial sacral, magnesium and a bunch of stuff I can't remember right now. Guess he's kind of an extreme case. :)

What does the job for him now.... a combo of Enzymedica DIGEST and also Renew Life CLEANSEMORE. The digestive aid helps break down the food and the Cleansemore contains rhubarb and triphala (combo of three Indian fruits) and it increases peristalisis (movement of stuff through the GI tract). If we give him only one it doesn't work. You need to research stuff.... know what your child is taking and its potential side effects. Don't go by just one website or study. There are some sources I trust a lot more than others. Also a good naturopathic doctor can be so helpful. Rhubarb is high in oxalates and may contribute to kidney stone formation. We work to counteract this possibility by giving Jack some Red Mineral Algae with each meal along with the Cleansemore and Digest. The Red Mineral Algae is a source of natural calcium. This can help prevent stones. :) Jack goes approx. twice daily on his own. I give him extra slippery elm with each meal (there's also some in the Cleansemore) because it's soothing to the digestive tract.

Fresh cabbage made Jack poop like crazy.... but strange behaviors began to kick in quickly with that so we had to stop it. (I've heard of this before in relation to cabbage & DS-Andi) Senna and Cascara Sagrada are too harsh and can cause harm when used long-term.

Mom, Jayme, to Vision (23 mos) shares her strategy

Find below some things that I have tried with moderate success and a couple of other things that have been really essential, in my opinion, in keeping Vision pooping every day.

Moderately successful

• fresh peach sauce
• not feeding anything made with any kind of flour, whole grain or not; so, no breads or pancakes or cakes or pasta
• 2 or 3 TBSP of amaranth cooked with Vision's grains
• prune sauce
• not feeding bananas or apple sauce
• lots of fiber
• fresh vegetable juice made with carrots, parsley, bok choy, kale, chard, spinach, beets, (and sometimes pears or pineapple)

The clinchers, in my opinion

• giving 2 Trienza (made by Houston Labs) enzymes with each meal (they are expensive, but worth every penny, IMHO; I buy mine at www.enzymeco.com)
• giving 1/4 tsp sea buckthorn powder each morning (I got mine from www.znaturalfoods.com)
• keeping him hydrated
• giving him 1 tsp Inner Eco coconut water kefir daily

So, I am tossing out all this info. Look it over and do what you can do. If I could only do one thing, it would be the enzymes. They have made the most difference for him. They are also the most expensive thing on my list. The sea buckthorn powder would be the second thing on my list. He poops well every day, at least once, since I started him on it two months ago. It has also made a profound difference in his verbal processing and his physical development too. It has been a great supplement for Vision. Of course, it is hard to say if it would be as wonderful for your child, but think on all this.

Essential Oils for Constipation

http://www.heritageessentialoils.com/downsyndrome.php

From Linda Sherman, owner of Heritage Essential Oils:

...Before I knew about using essential oils, our baby daughter might go 7-8 days between movements if left to herself. I usually resorted to using glycerin suppositories to help her pass her bowels. The Digestion Support blend works very well for this issue. I applied a few drops on her abdomen at every diaper change, and she has never gone longer than a day without a movement since. I believe this blend helped strengthen her colon muscles so that within 6 months of consistent use she didn't need the oil. I still use it once a day because it has proven to be very helpful to prevent and eliminate parasites. Since it's been part of our routine for 3 1/2 years, we just keep it up.

Below is an interesting page from The Body Ecology site.
http://bodyecology.com/articles/experience_constipation.php

Do You Experience Constipation? Here is What You Need to Know and Do
Posted March 22, 2007. Excerpt:

Eat Your Way to a Healthy Colon

Health and disease both begin in the colon. If you struggle with constipation and want to heal your colon, start with what you eat.Eat foods that support colon cleansing:

* Avoid large amounts of salt, meat, and poultry. These are contracting foods that are more difficult to digest. We recommend that only 20-25% of a meal be animal protein. The rest of your plate should contain high-fiber vegetables, ocean vegetables and cultured vegetables.

* Eat lots of fresh vegetables. Lightly steamed, raw, baked...all veggies are an excellent source of fiber and several servings should be eaten at each meal The fiber in these foods helps push the food you've eaten through your intestines. 80% of each meal should be vegetables.

* Introduce sea vegetables into your diet. Rich in minerals they top the list with dark green leafy veggies for a daily must if you want to stay young and healthy. These often-overlooked vegetables provide trace minerals and nutrients that nourish both your thyroid and your adrenals. Weak thyroid and adrenals may be one of the most undetected causes of constipation and both organs need lots of minerals. A common cause of constipation is an under-active thyroid. Agar has been used in Japan to relieve constipation.

* Fruits. We do allow some limited fruit in the beginning stages of the Body Ecology Diet. As your candida symptoms disappear and you are certain your inner ecosystem is on its way to being established (by eating and drinking fermented foods and beverages), you can add others. But some fruits are very sweet and others less so. Choose the very sour fruits like grapefruit, lemons, limes, unsweetened cranberry juice, black currant juice, unsweetened blueberry juice concentrate, and pomegranate juice. These juices are wonderful sources of antioxidants and are great when you add them to a microflora-rich beverage like Young Coconut Kefir.

* Always include ground flax seed in your diet...

* Include fermented foods and drinks. Cultured vegetables and fermented beverages populate your gut with good bacteria to help you digest food and assimilate nutrients.

* Milk kefir has been a remedy for healthier bowels and better elimination for thousands of years. But why? Is it because of the wonderful bacteria and yeast or because of the tryptophan?

* Tryptophan converts to serotonin in your body and serotonin influences the peristaltic action in your colon. (An added bonus is that it also improves your mood.) Be aware of drinking too much kefir or it might also cause constipation instead of relieving it.

* Milk in large amounts can be dehydrating for some. In ancient Aryuvedie texts fermented milk was combined with water to create a more balanced food. This mixture was called "kurdwater" and was recommended often as a treatment for many different kinds of digestive disturbances.

* Make sure you get your magnesium. Magnesium may top the list of all the many minerals we are deficient in today. Magnesium is the calming mineral. A lack of it will contribute to constipation.Try to increase intake of magnesium in foods or take a magnesium citrate supplement, like Peter Gilliam's CALM orMagna Calm. These two are powders and can be taken by children to help them move their bowels.However, Donna feels it is important to have other types of magnesium supplements as well. Magnesium chloride from the Pain and Stress Center in Texas is one of our favorites. You can also purchase Magesium Asparate from your health food store in capsules. Take 400-1600 mg per day to help relax you and to help your bowels move on a regular basis.

* Eat garlic. Garlic is a healing, anti-microbial, cleansing food. Cook with it as much as possible and even swallow it whole.* Eat Body Ecology grain-like seeds.Cooked millet, quinoa, buckwheat and amaranth stimulate your colon, provide fiber and can ease constipation.

* Drink mineral water. If you feel too energetic at night to sleep and stay up late yet feel exhausted in the morning, you may be experiencing signs of dehydration.Yes, the inability to feel sleepy can come from not drinking water during the day. Solve the problem by drinking several glasses of mineral-rich water in those three to four hours between your dinner meal and bedtime. Drink two more glasses when you wake up. Keep track of your water intake during the day to make sure are well hydrated.Dehydration can be a sign of adrenal fatigue, however, and no amount of water will help until you heal your adrenals. 

This is Dr. Paul Doney's page on constipation. He's a chiropractor in Australia who has a child with DS.

What does the look of stool tell you?

A great guide to figure out what you can learn about your child's health by looking at stool: http://gapsdiet.com/Stools.html

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