Friday, September 15, 2023

constipation in autism kids

It's not uncommon to have constipation in kids with autism. It's seen in around 70% cases.
It is hypothesised to be due to lack of sensing the gut distention for evacuation and child starts reatining motions /stools inside.
In most kids it's not per se constipation to hard stools. But if the child has 5o strain, it's better to call it constipation and manage as early as possible.
A child refusingt I sit for potty or doingw eird gestures at potty time or making legs curved or not sitting properly or had pain or discomfort is likely to have indigestion which eventually causes constipation. 
The gut is 18 feet long and if the child passes less than 4 inches motion block at a time, it's likely 5o be constipation.
It's again constipation if the child passes very smal pellet like stool balls or smelly or gassy stools mean the child is retaining a lot and most potty is getting fermented and smelly.

Why do we need to know about constipation in autism kids? 
It's mainly because it adds to restless irritability crankiness indigestion reduced appetite poor weight gain and reduced water intake. Remember crankiness of constipated Amitabh Bacchan in movie Piku.
Eating less and drinking less is not a reason for constipation but it happens due to constipation.
Commonest constipation diet is hard food like high protein diet, dry fruits, milk, hard daals and pomegranate .
Soft foods like rice and potato being easy to digest cannot cause constipation.
Constipation is also possible due to some nutrients like fish omega or calcium or phosphate containing tablets.
Best way to treat constipation is not by giving extra water or adding fibre or dry fruits or fruits vegetables .
Best way to treat constipation is by using stool softeners, non absorbable sugar syrups and avoiding constipationg 4d diet as mentioned above. Google for *4d minus diet* for same.

It's common to have indigestion or not passing motions or reduced intake or crankyness with constipation.
There are some probiotic and enzyme supplements that help in constipation.
Constipation with blood ina tools and constipation with daily vomiting will need tests to rule out medical serious emergencies like intussusception, intestinal obstruction or pseudoobstruction or tuberculosis
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Standard sampleof advice given by a dr in a case of hard stools:in a 2 year old kid
In such situations

Syr gutclear / dofotil 10 ml 3 times a day for 3 days

If no relief double the dose for next 3 days

If no relief
Maintain 10ml 3 times a day and 
Add rectal suppository hallens glycerine  2gmsuppository or dulcolax suppository or babie less than 2 year age u can use neotonic enema.
Above medicines donot get absorbed in blood but just pull the potty out of body, meaning usually simple extra dose is harmless.
If loose motions, stop all of them.
Aristozyme drops 1 ml daily for 1 month, can be increased.

Can be continued long term. It doesn't cause habit.

Dofotil/gutclear/duphalac/laxolite/peg clear/evaq /move out etc all are same and dose is no limit when it's blocked gut.
For vomiting give domstal baby drops 1ml 3 times a day as needed


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