Friday, 8 April 2016

Bowel Health - Didn't Poop for "99 days."

There is not much room at the bottom of the pelvis in a pre-school or an early elementary school-aged child. The bladder and the bowel are situated side-by-side at the bottom in the most narrow part of the pelvis. The bones don't move. The bladder is affected by the pressure of the stool. The bladder cannot push solid poop out of the way. Solid stool pressing into the bladder compromises bladder control (holding postures, urgency, daytime dampness) and reduces the bladder size (peeing frequently, waking up to pee at night, bedwetting).

Once a child is at least six years of age they are able to answer questions about their pee and their poop. I routinely ask the child questions about how often they poop. One of the questions I ask is, "Do you poop every day or are there some days you do not poop." Most of the children I see respond that they do not poop every day. If they miss days, a follow up question is whether they miss one day at a time or more than one day. If more than one day, I ask if they might ever go more than two days, and so on until the child settles on their best estimate of how many days they might miss in a row.

A six year-old recently told me he could go "99 days" without a poop. Most children at his age do not really understand big numbers. This child was telling me in his own words that he missed many many days in a row. 

Most children only miss one or two days at a time. An every other day pattern is very common. Missing two days at a time means only two poops a week and this is also common. About once a month I talk with a family with a child who can miss a week of poops. About once or twice a year I hear a credible story that fits with going two weeks without a a poop. Going more than two weeks without a poop is rare. I have only heard this from a few families over my professional lifetime. 

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