Constipation - high fibre diet needed

[Somanybabyseagulls]

DD has suffered with constipation for a long time, doctor now thinks it's dietry. She has a very small appetite, eats fruit and veg, drinks lots of water. She likes bran flakes and weektabix. GP says she needs more fibre, ie bran and oats. Can anyone suggest anything that a 7 year old would eat? TIA

• Wholemeal, granary and softgrain varieties of bread
• Jacket potatoes, new potatoes in their skins and baked potato skins
• Wholegrain breakfast cereals, eg. Weetabix, branflakes, unsweetened muesli, Shreddies and porridge oats
• Wholemeal pasta and brown rice
• Beans, lentils and peas
• Fresh and dried fruits ? particularly if the skins are eaten
• Vegetables ? particularly if the skins are eaten
• Nuts and seeds
• Wholemeal flour

Homemade or bought flapjacks, lots of carrots, stewed apple - 2 whole apples makes a manageable bowl for a child to eat. Use an eating apple such as cox's and it will be quite sweet enough. Dried fruit - must cut up small or chew it well. Prune juice - wonderful stuff. Live yogurt or yakult. Be careful about too much bran etc - small children have small bottoms IYSWIM, and too much bran makes a very large poo. Then it is painful, and they hold it in even longer. Is she passing small, infrequent, hard stools, or is she holding on to a large one for too long because it hurts? It is important to differentiate because the treatment is different in each case. Is she holding on to it and overriding the natural urge to defaecate because she is unhappy using the school toilet, for example?? there are lots of reasons why children get constipated - hopefully your GP has investigated all.

Thanks for this, really helpful. She is actually holding on because it is painfull.

Well - sorry to disagree with your GP, but I really think more roughage making bigger poos is going to make things worse. She must have had a bad experience at some point and is scared to do a poo because of the pain. So i would go the route of prune juice and live yogurt (not together!!) and try to stick to a routine of regular meals and a private, adequate, peaceful time in the toilet. Explanation and reassurance is very important. There may even be a psychological reason for this, and it can become a real problem. Try to think back to how it all started. My dd had this problem after she had chicken pox and I gave her piriton. The piriton caused her gut to dry out leaving an enormous solid mass that was agony to pass and caused a tear in her bottom. It was awful and took me a couple of years to sort out. I still have to watch her diet. She hates the school toilets, so we get up earlier so she has time to sort herself out in the mornings. My lovely GP prescribed a long term treatment of Docusate, senacot and lactulose together with glycerin suppositories when required. She warned me it would take 6 months to a year, but it was worth it. Dd doesn't need any medicine or suppositories now, but I make sure she has cooked fruit and carrots and loads of water, but only a limited amount of high fibre so that poos are not large.

Is she restricting her food intake in order to have to go to the toilet less?

Thanks for that frogs. Don't think she's deliberately not eating, she has always had a small appetite. I can see your reasoning about the roughage, hard to know what to do for the best. She does get 'quiet' time for the loo but sometimes she can be bunged up for days! Appreciate this is going to take a long time to sort, guess it's trial and error mostly.

Syrup of figs - in a small bottle in Boots (Califig?). Raisins or oranges always works for mine. I'm surprised shes constipated when eating bran flakes? Maybe other parts of her diet may need tweaking - plain bread, cheese, bananas or chocolate could be binding. Lots of water very important.

sounds like she is holding on as long as she can. she needs "re-training" because she has learned to override her body's natural functioning. This treatment I mentioned is quite well known and really works. the docusate breaks up the hard lumps in the rectum, the senacot boosts the normal expulsive action of the gut, and the lactulose holds water in the gut so that the stool is soft and easy to pass. Once she has experience of painlessly passing a soft stool, her fear will subside and she will stop holding on for days. Sorry about grammar etc - i am cooking dinner!

Avoid bananas!
My 4yo ds suffers from constipation ever since he had an anal fissure while potty training.
He is on a high fibre diet - weetabix, bran flakes, wholemeal bread, skins lft on potatoes when mashed (in fact I hardly ever peela vegetable, just scrub them), grapes, raisins, fresh orange juice, and he has a very small nightly dose of Senokot on prescription.
But bananas a re a fruit to avoid, as they are constipating, where other fruit is OK.
Hope you can sort this out. With more fibre, my ds had more poo, but it was so soft that he didnt notice it coming out. I can see 3litlefrogs reasoning, but if the poo is soft then the quantity isnt an issue. Also, more bulk and fibre in the gut helps to speed up the passage of faeces, therefore they lose less water in the large intestine (where it is reabsorbed) and so they are softer.