Ways to Relieve Constipation in an Autistic Child

There he was again, stiffening up like a board to try to hold in the same poop he’d been withholding for the past two days. Sigh. I ran over and scooped him up, since I caught him in the act, and quickly pulled up his knees to his chest. After an intense scream, there was finally relief. I was so tired of this constant battle, so tired of seeing my toddler suffer, and so tired of not finding the answers. I tried everything in the book, and finally found some ways to relieve constipation, and get my little guy out of the vicious cycle of withholding.

Why do autistic children struggle with constipation?

There are actually a few different reasons that autistic children struggle to stay regular. It is a well known fact that most children with autism also have gut issues, and that there is a “brain-gut connection.” Their stomachs are typically more sensitive to gluten, dairy, and artificial ingredients, which often leads to trouble digesting food properly. Add sensory issues and food aversions to that, and you’ve probably weeded out most healthy, high-fiber foods.

And speaking of sensory issues, many children on the spectrum struggle at the other end, because they simply don’t like the sensation of having a bowel movement. Whether the child is afraid of the sound that it makes in the toilet, or of the feeling in the first place, or the itchiness of the toilet paper, there are plenty of sensory flags being thrown out during the pooping process.

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Whatever the reason, your kid simply doesn’t like to have to use the bathroom. This often leads to withholding. That’s when they actually try to stop a bowel movement from occurring. They may squeeze with all their might, stiffen up their legs, or sit on something to try to keep the poop from coming out. This process of withholding actually causes constipation.

Every time your child withholds their bowels, they allow more poop to build up at the end of the colon and in the rectum. Hey, what did expect to read about here?! The more poop that piles up, the farther the rectum stretches out. Over time, it begins to stay stretched out, so it takes more and more buildup to signal the brain to release it. Yikes! This can cause long term digestive issues and chronic constipation.

In order to stop the cycle, you must completely clean out the bowels, and then regulate them for at least 6 months to allow the rectum to shrink back down to size. So how can you do that? Talk to your pediatrician about a Miralax or milk of magnesia clean out. They should be able to give you exact doses, based on your child’s weight, to help clean out their bowels, so you can begin a supplement regimen to maintain regularity.

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Ways to combat constipation

You have probably been told to add prunes to your child’s diet, and to give them Miralax. Those are the first two things every doctor seems to recommend. Those are simply Band-aids though. It’s always better to address the root of the problem and actually solve it. So here are 6 steps you can take to relieve your child’s constipation.

Create a healthy gut environment

Digestion usually starts to go wrong in the stomach. A healthy gut environment can help your body properly process its food. Taking probiotics on a daily basis can create a thriving environment for good bacteria, which keeps your tummy happy. Sad tummy = bad digestion. Happy tummy = more willing to work for nutrients.

There are probiotic powders available for infants and children, which you can sprinkle on their food, or in a drink. They are typically tasteless. We prefer GoodBelly, a dairy-free probiotic shot. While it is more expensive, it also contains fiber, and it is significantly more effective than powdered probiotics. Either way, adding probiotics to your child’s diet can help heal the gut and give their food a better chance at being properly digested.

Eliminate irritants

Gluten, dairy, artificial colors, artificial sweeteners, refined sugars, artificial flavors, and preservatives are highly aggravating to the digestive tract. Children with autism tend to be more sensitive to these irritants. I know how difficult it is to introduce new foods (or brands!) to children on the spectrum, but if you can avoid these ingredients, it can make a world of difference for your child’s gut health.

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Help the body digest

Digestive enzymes are our best friends. You can fight constipation by helping your body digest. Enzymes are special proteins that break down other large molecules, like the ones in your food. They speed up chemical reactions and help your body digest food faster and more effectively. That sounds like a good way to relieve constipation, right? It is!

We use VitaZymes digestive enzymes. They have proven to be much more effective than the kids enzymes we found at the health food store. Our chiropractor recommended them, and they have definitely helped a ton!

Draw water into the colon

Drawing water into the colon helps maintain regularity. If there is not enough water in your bowels, you can quickly get constipated. I am not a fan of using Miralax on a regular basis. The whole idea of giving something to my child that warns not to give it to “persons under 17 years of age” makes me cringe. Sure, I’ll use it for a clean out, or for an occasional bout of constipation, but certainly not on a daily basis.

There are other healthier ways to draw water into the colon. The most simple way is to increase your child’s water intake. If your child doesn’t drink water, begin adding small amounts to whatever drink they take, and begin gradually watering it down. Or use a first-then board to begin motivating them to drink water first, then the drink of their choice.

Drinking warm lemon water (or just plain warm water – bleh!) is a highly effective way of increasing water absorption in the colon. Warm water is immediately taken in by the bowels, so drinking a cup of warm lemon water in the evening can typically cause the bowels to begin moving by morning.

Aloe vera water is another great way to increase water uptake by the colon. If you try that, just make sure you don’t get one that’s packed with sugar!

We prefer to use magnesium to draw water into the bowels. Natural Calm is a fairly tasteless powder that I add to my boys’ drinks. It does give it a bit of fizziness, but it resolves if you wait a few minutes before serving it. If your child enjoys fruity flavors, they have a super line of tasty ones to try. Check with your pediatrician for a dosage before trying it, because the packaging gives adult doses. Magnesium increases water absorption in the colon, and also has a calming effect, so this is the perfect night time drink!

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Encourage bowels to move

Sometimes your bowels just need a bit of encouragement. If your child is eating fiber, taking digestive enzymes, and still having trouble going, it may be time to add a stimulant. There are children’s laxatives that can be purchased at your local pharmacy, but try the natural route first. Senna tea is a great alternative to chemicals in over the counter medications. One cup of Traditional Medicinals Smooth Move per day does the job. I sweeten it with stevia and use a syringe in order to get my two year old to take it…hey, whatever works, right? Senna will actually stimulate your child’s bowels to move, so this typically works if the previous steps haven’t.

Assist physically if necessary

This is never fun. If your child simply can’t pass their stool, you may need to use a glycerin suppository or enema. If your pediatrician has advised you to use a suppository, you may want to try using a syringe in place of the bulb that comes in the package. The tip of an average 5 ml syringe (from infant’s acetaminophen) is much smaller than the end of the bulb, and it is much less painful for the child. This is the fastest way to relieve constipation. The solid glycerin suppositories work much slower than the liquid ones, and often get passed before they dissolve. If you only want to do it once, go for the liquid!

The other way you can assist physically is by moving your child’s legs. If your child is withholding, you may need to physically help them move their legs in order to stop them. Scoop them up and pull their knees to their chest. This relaxes the muscles and allows the stool to pass. Yes, it is painful, but far less severe than a ruptured bowel. If your child has gotten to this point, please talk to their GI doctor or pediatrician about performing a bowel clean out at home, and moving forward with a regimen to stop the cycle of constipation.

Our daily regimen to combat constipation

My boys are two (almost three!) and four years old. This is our daily regimen. Please be sure to check with your child’s doctor for correct doses before using these supplements at home.

Morning:

• 1 VitaZymes
• 1 GoodBelly
• 1/4 teaspoon Natural Calm

Evening:

• 1 VitaZymes
• 1 cup senna tea
• 1/4 teaspoon Natural Calm

After performing a bowel clean out under the direction of their doctor, this regimen has worked wonderfully to keep my boys regular! If your autistic child is struggling with bowel movements, try these steps to help relieve constipation quickly and effectively! Let me know if you have had success with another great product!

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