Constipation is one of the ten most common health problems in children; up to one-third of children who consult with pediatric gastroenterologists suffer from it. In 95% of the cases, it is functional constipation, so-called when there is no underlying disease. Many times, the origin is inadequate toilet training, toilet phobia or rejection, and restrictive dietary regimens. Critical in this condition is the training period, when children go from two to three bowel movements a day to once a day, after the age of three and throughout their lives.

The symptoms associated with constipation are recurrent and often disabling, disturbing sleep, and hindering the social development of children. Concomitantly, it is not uncommon for both children and adults to develop psychological disorders such as anxiety and depression with this problem. Pediatric gastroenterologists comment that the prevalence of constipation has increased in children due to the anxiety caused by the current pandemic.

Pediatricians treat constipation with laxatives, and half of the children are relieved, but the rest remain constipated for up to five years of treatment. According to some specialists, treatment with probiotics or motility stimulators are not effective, and pelvic physiotherapy and sacral nerve stimulation are promising options, but require further testing.

However, the most accessible treatment to prevent or alleviate the problem of constipation is dietary modification. According to the latest National Health and Nutrition Survey, 64% of Mexican children under five years of age consume unhealthy snacks and sweets, 49% eat sweetened cereals for breakfast and 83% drink sugary beverages daily. Only 37.5% of children in this age group eat beans; slightly less than half eat any fruit and only one-fifth of children eat vegetables. This way of feeding infants does not provide them with enough dietary fiber, and therefore they are exposed to constipation. It is necessary to give them more fruits and vegetables every day, as well as legumes such as beans or lentils.

Adolescents, in their eagerness for independence, are an age group with a less balanced diet than any other group. They drink less water, consume fewer legumes, fruits, and dairy, and more fast food than minors and adults (Ensanut, 2018). In addition, they spend many hours of physical inactivity with their video games, recorded music, and computers. Because of this, it is not uncommon for them to suffer from constipation, when a few years ago they were the group with fewer such problems, due to their physical activity.

Currently, constipation is prevalent in adults, even young people, as opposed to two decades ago, when it was a problem of older people. For them, lifestyle changes and diet modification are recommended to alleviate symptoms of chronic constipation. Physical activity is very important, starting with twenty minutes of walking per day, which will result in many health benefits. Supplementation of an extra source of fiber is not recommended, if at all, soluble fiber such as psyllium, but not bran. The most effective is to take fiber from food in natural form; fruits, vegetables, and legumes are good sources.

It is very important to follow the recommendations because if not treated properly, constipation becomes chronic and increasingly difficult to control. In addition to a diet rich in fiber, sufficient water, and daily exercise, it is recommended not to self-medicate. The accessibility of antacids and proton pump inhibitors is a temptation for many, but they end up exacerbating the problem of constipation.

By Ana María Calderón de la Barca, researcher of the Nutrition Coordination of CIAD.