Did you know that your child’s refusal to pass bowel movement could be linked to their emotional state (anxiety, fear)?
Is your child often grumpy and irritable, holds in his poop for days at a stretch simply refusing to go potty? When he finally does pass a bowel movement, does he cry in pain, strain and say “it hurts”?
Then you are not alone.
There are a large number of children who habitually withhold their bowel movements. These children then tend to pass very hard stools, which can be painful. This leads to a lot of tears and tantrums, and can create concern and frustration for many parents.
However, despite this not many parents pay much attention to their child’s bowel movements until it becomes a source of serious concern, often requiring a visit to the doctor.
In order to avoid the tearful visits to the doctor, it is important that you are able to understand the reason behind why your child is withholding his bowel movements. This will help you take preventive measures and hopefully stop the problem from arising again.
Brain-Stomach Connect: Our bodies react to the way we feel
When their child withholds his bowel movements and then passes painful hard stools, most parents tend to automatically examine his diet — what is he eating, what is he not eating, is he eating the right things in the right quantities.
You could be worried about the “heatiness” in your child’s body and look to his diet for solutions.
However, while diet is important, sometimes your child’s refusal to pass bowel movements could have nothing to do with it at all – it could actually be linked to his emotional state.
Yes, anxiety can cause your child to withhold bowel movements.
Research shows that our digestive system has a very strong connection to our braini,ii. This means that if your child is suffering from negative emotions, such as anxiety, it is bound to impact his digestive system. When your child is worried (and unable to express or vocalize his feelings) it could slow down some of his body functions such as passing bowel movements.
You would have noticed that whenever you are stressed or anxious, it possibly has a direct impact on your stomach as well – you could feel nauseous, have short-term diarrhoea, or have hard stool and be constipatediii. It is no different for childreniv
The Vicious Cycle
However, here is the interesting thing. The source of your child’s refusal to poop could be his inability to poop itself. The variety of reasons could include any of these: he may feel self-conscious about going potty in his day care, he may be worried about making a mess, he may feel uncomfortable sitting on the pot, or he may just have witnessed another child being scolded for having an “accident” and may be worried the same will happen to himv.
The withholding of bowel movements leads to children passing hard and painful stools, and this in turn can make them refuse to go to the toilet. Children are fearful of the pain and do not want to repeat the experience, and therefore withhold bowel movements.
As you can see, at times it is difficult to pinpoint the exact cause of why your child starts to withhold bowel movements. However, whatever the initial cause, holding of stool leads to larger, more-painful stools, which lead to the child trying even harder to withhold the stool.
This then becomes a vicious cycle: Child has hard painful stools → fearful of repeating the experience → withholds bowel movements → has hard painful stools.
Breaking the Cycle: Figure out what came first
In order to break this cycle, you need to get to understand the reasons why your child is withholding bowel movements. Is it because his digestive health is poor, is it because his emotional health is poor and is impacting his digestive system, is he fearful of causing a “potty accident” or is it the fear of painful and hard stools?
Once you have identified what the original problem is you can begin to take remedial measures.
iKeunen K, van Elburg RM, van Bel F, Banders MJNL. Impact of nutrition on brain development and its neuroprotective implications following preterm birth. Pediatr Res. 2015 Jan;77(1-2):148-155.
iiLyte M. Microbial endocrinology in the microbiome-gut-brain axis: How bacterial production and utilization of neurochemicals influence behaviour. PLoS Pathog. Nov 2013; 9(11): e100372
iiiElsevier. “Stress affects the balance of bacteria in the gut and immune response.” ScienceDaily. www.sciencedaily.com/releases/2011/03/110321094231.htm (accessed May 5, 2017).
ivDaniels, N (2015) How to Parent your Anxious Toddler
vPediatrics (1999) Toilet Training Guidelines: Parents – The Role of the Parents in Toilet Training, Pediatrics, June 1999, VOLUME 103 / ISSUE Supplement 3 Retrieved on May 5, 2017 from: http://pediatrics.aappublications.org/content/103/Supplement_3/1362
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