Medical Expert Corner – Everybody Poops, with Danielle Schwartzenburg Takacs, M.D.

Danielle Schwartzenburg Takacs, M.D.
Assistant Professor, Department of Pediatrics and Neurology
Neurophysiology and Epilepsy
Baylor College of Medicine/Texas Children’s Hospital

Sure—It’s a messy issue, but very important.  

Your poop can tell a lot about your general body health, such as adequate hydration, adequate fiber intake, and gut motility. 

One of the most important GI issues in people who have neuromuscular conditions is constipation – this is because the intestines are essentially muscular tube – and therefore those muscles can certainly have reduced function and strength, similar to  the way that other muscles may become weak. Reduced overall body movement can also often lead to constipation as well.

Constipation occurs when bowel movements become less frequent and stools become difficult to pass. It happens most often due to changes in diet or routine, or due to inadequate intake of fiber. You should call your doctor if you have severe pain, blood in your stools, or constipation that lasts longer than three weeks.

While each person’s poop schedule is different—some people may go once per day, others every 1-3 days, and some people may go several times per day…the technical definition of constipation is LESS THAN 3 bowel movements per week.

Perhaps the most important aspect of your #2 is not just the timing, but its consistency (I know, I know, gross!) but the chart below can help you gauge whether you or your child is having BM’s that are A-OK!

Regardless of any one individual’s pooping pattern – one fact is certain; the longer time you go before you “go,” the more difficult it becomes for the stool/poop to pass.

Other key features that usually define constipation include:

  • Your stools are dry and hard.

  • Your bowel movement is painful and stools are difficult to pass.

  • You have a feeling that you have not fully emptied your bowels.

Tips on how to manage constipation

  • Drink plenty of water – Add an extra 2-4 glasses of water per day. Dehydration leads to stool getting hard and dry!

  • Eat more fiber – Fruit, vegetables, and whole grains add fiber to the diet. The “P fruits such as Prunes, Peaches, Pears, and aPricots have high fiber. Supplements such as Metamucil/Citrucel/benefiber can also be added.

  • Reduce dairy/cheese intake as these often worsen constipation

  • Stretching/exercise helps stimulate gut movement

  • Medications, (which should always be discussed with your doctor) such as:

    • Stool Softeners – Polyethylene glycol (Miralax, Glycolax), Colace

    • Stimulant laxatives – Senna, Bisacodyl

    • Sometimes a “cleanout regimen” (like when your house pipes get clogged!) may be needed – taking several doses daily – in a plan made together with your doctor

At times, even these medications taken at home may not work – in which case you should seek care either with your doctor, the urgent care, or the emergency room – as sometimes additional measures such as enemas, or even procedures to break up stuck stool may be required. 

For more information or resources you can also see the following videos and websites:

https://youtu.be/0IVO50DuMCs

https://kidshealth.org/en/kids/constipation.html

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