Published in the Journal of Paediatrics, the first study of its kind found that chronic constipation in children who are picky eaters leads to difficult toileting behaviours.
Researchers from Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, USA, found that normally developing preschool children with chronic constipation have underlying sensory issues that contribute to their difficulties with toileting behaviours.
Chronic constipation in children
These children are often picky eaters who might be overly sensitive to food textures, tastes, or odours. They also might have an exaggerated response to noises, bright lights, or other sensory stimuli.
Senior author Mark Fishbein, MD, paediatric gastroenterologist at Ann & Robert H. Lurie Children’s Hospital of Chicago and Associate Professor of Paediatrics at Northwestern University Feinberg School of Medicine explains: “Our study is revolutionary, revealing that chronic constipation in young children accompanies heightened sensory sensitivity.”
“In many cases, chronic constipation might be the first hint that the child also has some sensory issues and could benefit from occupational therapy. Feeding problems due to sensory sensitivities are especially common in these children and they are best addressed when kids are under 5, before maladaptive behaviours become more entrenched.”
Details of the study
In the study, Fishbein and colleagues assessed the differences in sensory processing patterns between 66 children, 3-5 years of age, ensuring chronic constipation in children was present and then matched group of 66 controls.
They also examined how the children’s sensory profiles correlate to atypical toileting behaviours. They determined that chronic constipation in children showed increased responses to sensory stimuli and increased avoidance behaviours.
Heightened oral sensory processing (sensitivity to food textures, tastes or odours) emerged as the most significant factor in predicting the child’s tendency to behaviours such as withholding stool or overall bathroom avoidance.
Increased sensory activity can create discomfort
“On the surface, the association between oral processing and constipation may not seem intuitive,” says Fishbein. “However, increased sensory sensitivity can create discomfort and lead to avoidance, and we see that response in both food refusal and in the toileting behaviours of children with chronic constipation. Both feeding problems and constipation may develop as a result of sensory processing difficulties.”
Recognition of the association between chronic constipation and sensory sensitivity could transform clinical practice.
“Our study offers an expanded tool kit to clinicians who care for children with chronic constipation,” Concludes Fishbein. “Comprehensive care of these children should include consideration of sensory issues and possible referral to occupational therapy.”