This is the most common question in constipation clinic!
The answer for most families is IDIOPATHIC…which is code for “We can’t really explain this.” Unsatisfactory? You bet.
Instead, a simple framework sorts constipation into distinct patterns that can be understood. Remember, it’s J.U.S.T. constipation.
What does J.U.S.T. stand for?
- J is for Juvenile: In the first year of life, babies undergo numerous changes and are still developing. Stool patterns can be wildly unpredictable. The key to this phase is supported bowel training, in the same we ‘sleep train’, support feeding, walking and language acquisition.
- U is for Unexplained: Yes, for some children we never quite find a rational explanation. The strategy here is accepting the tendency towards constipation and managing well with diet, medications etc.
- S is for Syndromic: There is an overarching diagnosis that comes with a tendency to constipation e.g.
- Children with developmental delay on long term tube feeding have a restricted, low residue diet
- Children on the autism spectrum may have sensory issues that hinder defaecation dynamics, or restricted diets that pre-dispose to constipation
- T is for Transitional: Seen in toddlers and older at times of transition e.g. home to nursery or school, toilet training, travel. Withholding behaviour , prolapse and anal fissures are common in this group. The key for this group is breaking the cycle, establishing a bowel routine and long-term dietary hacks.
