Irritable Bowel Syndrome Message Boards

I agree, it might help to take him to a gastroenterologist.

Here is some general info fyi, some might not apply do to his age.

but

FYI

Defecation Anxiety Linked to Functional Constipation in Children

Charlene Laino

Oct. 15, 2003 (Baltimore) � Children with functional constipation have significantly more anxiety related to toileting behavior than healthy children � anxiety. This anxiety makes them more likely to continue to suffer from the problem, a prospective study suggests.

Moreover, some of these children develop generalized anxiety, reported researchers from the Cleveland Clinic Foundation.

"Constipated kids were not generally anxious overall, but among those with defecation anxiety we saw an increase in general anxiety," said Gerard Banez, PhD, a child psychologist at the Cleveland Clinic Foundation. "This does not prove cause-and-effect, but does suggest that those constipated children with greater defecation anxiety also exhibit increased general anxiety."

Painful bowel movements can make a child fearful of pain, Dr. Banez said. That fear can be generalized to sitting on the toilet.

The research was described here today at the American College of Gastroenterology 68th annual scientific meeting.

Up to 7.5% of children suffer from constipation, which accounts for about 3% of visits to pediatricians and up to 25% of visits to pediatric gastroenterologists, according to data cited in the study.

According to the researchers, constipation carries a host of physical and psychological consequences, and defecation anxiety is often implicated as a primary contributor to constipation.

Dr. Banez and colleagues studied 98 boys and girls aged 6 to 18 years who suffered from functional constipation. The youngsters completed the Defecation Anxiety Scale�Self-Report and Revised Children's Manifest Anxiety Scale, which measures generalized anxiety. The parents also rated their children's defecation anxiety on the Defecation Anxiety Scale�Parent Rating Scales.

By both self-report and parent report, children with functional constipation were found to have significantly more defecation anxiety than healthy children or children with asthma, the researchers said.

Overall, 70% of the children reported defecation anxiety compared with 58% of a control group of healthy children and 65% of children with asthma. The parents reported that 82% of their children suffered from defecation anxiety.

In addition, 30% of the children with constipation reported generalized anxiety. The greater the defecation anxiety, the greater the generalized anxiety, Dr. Banez said. Children with defecation anxiety have a higher chance of having generalized anxiety, although some children with no significant generalized anxiety still had defecation anxiety, he added.

Physicians who see children with constipation anxiety should rule out any medical cause, Dr. Banez said. Also, consider defecation anxiety in the differential diagnosis of any child whose parents report that their child seems to be withholding stool, is tearful at the urge to use the toilet, or shows vigorous resistance to using the toilet, he said.

Also, physicians should discuss strategies that promote relaxed toilet sitting as well as suggest dietary changes � possibly with a stool softener thrown in � to promote softer stools, Dr. Banez said.

William Whitehead, MD, professor of medicine at the University of North Carolina in Chapel Hill, said he has had some luck treating constipation anxiety with biofeedback, although he said that studies in Europe suggest that laxatives work just as well as the relaxation technique.

The question now, he said, is whether anxiety is the cause or the consequence of constipation. ?This study doesn?t really tell us, but it is still a major advance, the first trial I know of where they have linked defecation and anxiety directly using such a systematic approach.?

ACG 68th Annual Scientific Meeting: Abstract 723. Presented Oct. 15, 2003.

Reviewed by Gary D. Vogin, MD

Something just to know

Kids Take Sickness Cue From Parents

http://preventdisease.com/news/articles/kids_sickness_parents.shtml

FYI

J Spec Pediatr Nurs. 2003 Jul-Sep;8(3):81-9. Related Articles, Links

Recurrent abdominal pain in children: forerunner to adult irritable bowel syndrome?

Jarrett M, Heitkemper M, Czyzewski DI, Shulman R.

Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, USA. jarrett@u.washington.edu

ISSUES AND PURPOSE: Review the etiology and pathophysiology of recurrent abdominal pain (RAP) and its potential role as a precursor to irritable bowel syndrome (IBS) in adults. CONCLUSIONS: Physiological mechanisms not easily identifiable as an organic cause may underlie symptoms in RAP patients. They may be triggered by psychosocial factors that result in greater functional disability, more clinic visits, and lower academic and social competence. Of these children, 25% will experience similar symptoms as adults; many will be diagnosed with IBS. PRACTICE IMPLICATIONS: Nurses can provide early and efficient management of these children's care if they view the issues of abdominal pain/discomfort from a broader focus that includes the context of the child's experiences.

PMID: 12942886

Mind-Body Technique Eases Kids' Gut Pain

Kids Have Fewer Days of Abdominal Pain When Using Relaxation Technique

webmd

http://my.webmd.com/content/article/72/81542.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}

and a really good gi health site for kids

About Kids GI Health

http://www.aboutkidsgi.org/

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My website on IBS is www.ibshealth.com

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