Featuring Dr. David Israel, BSc, MD, FRCPC

Duration: 2 minutes, 23 seconds

Managing constipation that is more complex with stool withholding and soiling, takes time.

And one needs to prepare to invest several months to sometimes years for this purpose. There are three or four stages that need to be achieved befoer the problem is completely addressed.

In the first stage one needs to make sure that the stools are soft and non painful. In the second stage stools should be there on a daily basis in a good amount.

And then a third stage comes when we build up the habit of bowel elimination, and those efforts would lead after time to the last stage that everybody wants to achieve, which is independent bowel elimination with no constipation, no soiling.

In addition, it's very important especially in children, to look at the age and understanding of what's going on. Often enough a child would have to have the maturity understanding of about six to seven years old, boy or girl, about the school age to understand what is required and what's going on.

Family often are looking for a fast fix or something that would magically alter the problem. It doesn't exist. Families need to be very patient, very consistent, and follow those three stages. Once the habit has been formed and things are working clockwise one can say, that would be the first time that one can start decreasing the intervention, changing what we give the child to make them go.

And in here I mention all the stages. The last stage is independence where they child now independently goes to the toilet, has his bowel motion wihtout any hints or prompts from anyone else and without the need of any medications or preparations.

For those kind of things it's a long term interaction between the family, the family physician, and very importantly, the dietitian.

Presenter: Dr. David Israel, Pediatrician, Vancouver, BC

Local Practitioners: Pediatrician