Crohn's Disease Forum » Parents of Kids with IBD » Diet/Cooking for Kids with IBD » Anti-constipation diet.....(non-crohns)


04-20-2012, 11:26 AM   #1
Lisa
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Anti-constipation diet.....(non-crohns)

Tori had her annual physical yesterday, and one thing that came out of it is that she is constipated - actually will go a few days without having a BM and has had difficulty passing when she does....not always, but lately more and more often.

Her doctor has recommended adding more fiber to her diet, and cutting out/down on certain foods such as white rice, pasta and white bread, also to add fiber in the way of metamucil etc...he also said her bowel was full of feces - must have felt that with palpation.....

Can anyone share some ideas of higher fiber meals or dishes I could try for her? This is a 7 year old who eats almost anything - actually LOVES her broccoli!

I did get some Benefiber from my Mom, which I mixed with pink lemonade Kool Aide - and Tori liked it...so that part will not be hard. Dr also recommended she sit on the toilet for 10 minutes 2 times per day, regardless of producing anything - to try to get her body in the habit of going at a regular time.....started that this morning and my Mom will be having her do it in the afternoon after school....
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04-20-2012, 12:50 PM   #2
Zoodles
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My youngest (non crohn's) would have constipation issues. We would give him mineral oil for a few months to help get his colon retrained. Bizarre concept but it was recommended by our pediatrician. He took miralax for a week and the mineral oil daily until his stools were smaller.

My youngest would never sit still to go to the bathroom. Good luck to you and your daughter
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04-20-2012, 01:28 PM   #3
Tesscorm
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Stephen's older (17) but when he's had problems, I've given him a little bit of prune juice (approx 1/4 cup) for a couple of days, it seems to work for him.

Also, when Stephen was just a bit older than your daughter, he would sometimes be constipated and in pain, his doctor once suggested he try glycerin suppositories - they worked amazingly! He'd be in horrible pain, would have the suppository, have his BM 15 minutes later and the pain would be completely gone... as if it had never been there at all!
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04-20-2012, 02:25 PM   #4
Lisa
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need to add prune juice to the shopping list.....and maybe some dried prunes.....

We haven't had a lot of luck with suppositories - that kid can get wiggly!!!...although she is soooooooo good with other things, like taking cold medicine, even the all-natural oral stool softener/laxative I have given her in the past - which is pretty awful.....her trick is to have a cup of water ready and take a few sips immediately after.
04-20-2012, 02:37 PM   #5
Tesscorm
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My kids were pretty easy with suppositories - from the time they were infants, they were both unable to tolerate any meds that were swallowed (children's aspirin, cough syrup, etc.) - we started using aspirin suppositories when they were infants. By the time we got to the glycerin suppositories, I guess it was 'same old, same old' to him.
04-20-2012, 04:12 PM   #6
DustyKat
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Hey Paso,

All great suggestions above so I think the only thing I can add is that pear juice is also good for constipation. Often an apple/prune or apple/pear combination works just as well too.

Dusty. xxx
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04-20-2012, 07:11 PM   #7
Catherine
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Prune works great for us. For me it works very quickly and I need to be near a toilet for the next couple of hours.

For sarah it works more slowly. For her we start with 1/4 cup morning and night, increase the amount of prune each time until she clears.

Because your daughter is small, you may want to start with a small amount you don't want to sent her the other way.
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04-20-2012, 07:38 PM   #8
izzi'smom
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I only know of some high fiber stuff because we were trying to avoid it lol!
I remember beans, whole wheat pasta, peas, artichokes, and oatmeal being on the list.

A friend gave her son high fiber breakfast bars...he loved them! (Just remember not to give them two lol! She had a rough day that day)

We have added a basket next to the toilet in our house for Izz...she has bathroom books to help her pass the time-maybe this will help keep the 2 10 minute sessions from getting boring/noncompliance!

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04-20-2012, 07:53 PM   #9
rygon
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Have you had words with her about going to the toilet? A lot of ppl of all ages will dread going to the bathroom in public, this can lead to constipation

Making sure she has access to water at all times will help as well
  • Barley
    Navy Beans
    Baked Beans
    Split Peas
    Lentils
    Wheat Flour
    Oat Bran
    Dates
    Refried Beans
    Raspberries
    Asian Pears
    Green Peas
    Kellogg's All-Bran Cereal
    Couscous, dry
    Prunes
    Kellogg's Raisin Bran Cereal
    Spinach
    Spaghetti and Meatballs
    Artichokes
    Brussels sprouts
    Progresso Healthy Classics Lentil Soup
    Shredded Wheat Cereal
    Broccoli
    Pears
    Kellogg's Frosted Mini-Wheats Cereal
    Raisins
    General Mills Total Raisin Bran cereal

    Other high fiber foods include other bran cereals, bran muffins, etc.

    Foods that are still pretty good sources of fiber (about 2 to 4.9g of fiber per serving), at least as compared to other foods without fiber, but not as high as the high fiber foods listed above, include:

    Mixed Vegetables
    Strawberies
    Carrots
    Potatoes (with the skin on)
    Corn
    Rice
    Figs
    General Mills Cheerios cereal
    Apples (with the skin on)
    Oranges
    Air Popped Popcorn
    Oatmeal
    Applesauce
    Tomato Soup
    Fruit Cocktail
    Graham Crackers
    Whole Wheat Bread
    General Mills Honey Nut Cheerios cereal
    Pistachio Nuts
    Peanuts
    Celery

so maybe snack of nuts, sesame seeds and raisins will help.
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04-20-2012, 09:20 PM   #10
momoftwinboys
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One of my sons was given miralax for constipation. The GI also said to cut down on his milk consumption as that can help. Did not know milk had that effect.
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02-04-2013, 12:45 AM   #11
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I know this reply is coming way late, but for anyone dealing with constipation, there is a great book called Cure Constipation Now, A Doctor's fiber Therapy To cleanse and Heal. There is even a section on Crohn's Disease. It is written by a gastroenterologist Wes Jones, MD. I wish I had this book for reference many years ago. This is the most comprehensive information you will ever get on a step by step plan for dealing with constipation.

There are alot of different fiber supplements out there, and he talks about which ones are best to start with and then which ones you can move up to. He talks about it like training your bowels like if you are training for a marathon, and if you take off running before proper training, it can bring on set backs.

One word of caution, for those with sensitive stomach's is that Fiber One and Kashi cereals/bars can bring on alot of gas and stomach discomfort. Both of them have Chicory Root extract in them and even Dr Jones talks about how the manufacturer's should put warnings on the front of their boxes about this.

I am going through this also with my daughter, age 7 who suffers from constipation most of her whole life, and even when she is eating nutritiously, we still have to use the mirilax. Have been on 1 to 2 tsp daily for almost 6 years and trying to get her off of the meds by increasing her fiber, but she has a sensitive stomach and I believe she has problems with sugar alcohols which is also in alot of the different varieties of fiber supplements, so trying to find the correct one that doesn't cause her alot of gas and bloating. I figured this out because whenever I gave her prune juice (the new one without the pulp, she had the worst odorous gas I have ever smelled. Thus, we don't do the prune juice which has sorbitol in it (one of the sugar alcohol's).

One of the things Dr Jones talks about in his book (and this is for people who don't have a wheat intolerance/allergy) is that the best bread a person can buy that is available in many different cities is Great Harvest Bread. They don't sell their bread at grocery stores, you have to go to their bread store. The reason why Dr Jones recommends it is because their wheat is freshly ground daily. Their bread is expensive though, $6.00 a loaf in Nebraska.

Thus, I've been grinding my own wheat berries in my Nutribullet. You can use a vitamix also, with their grain grinding attachment, or even in a coffee grinder, or blender if you put it on the liquid setting. Grind the wheat berries for about one minute, and then put the flour through a tightly meshed metal strainer and swoosh it around a little but don't pound it, and then dump out the last little bit of harder peices.

Most of the flour a person buys at the stores, is bleached and then bromated and they are only using the endosperm of the wheat berry for the all purpose flours, which takes away all of the nutritional parts of the wheat berries and the fiber. Also, once the wheat berry is cracked open, every minute it sits on the counter, it starts loosing it's nutritional values (alot of B vitamins). I have tried the hard red and hard white wheat berries and the hard white is not as strong of a wheaty taste. From what I have read, they say it's best to start out with hard white wheat berries to make the adjustment. Also, you can mix an all purpose flour with your freshly ground flour to make a more gradual adjustment. King Author is supposed to be the best flour out there, if a person wants to start out with their brand vs grinding your own. They have quite a few different varieties of wheat flours and an amazing website with many reviews and tips. Another note, I have been using Hodgkin Mills quick rise active yeast which is supposed to be better for whole wheat breads. They give you extra yeast in each on of the packets, which helps with getting the heavier whole wheats to rise, so they aren't so thick, heavy and compact.
Larger HyVee's carry King Aurthor flours also, and they also carry some of the wheat berries if a person wants to try grinding their own flour. Whole Foods and some other health food stores also carry the wheat berries. Soft white wheat berries are used for pastries, cakes, donuts, pancakes, etc.

I am still working on my flour ratio's, that my super picky daughter will actually eat that I am making into bread. I did get a Hamilton Beach bread maker and have been very happy with it. Thought I would mention this as I read alot of reviews on different brands with alot not being so great. The Hamilton Beach only cost about $70.00. I ordered it online through JC Pennies and it was delivered to my house for free.

Hope this info helps someone out there.

All I can say is when I did get my daughter to eat 1 slice of the bread I made into french toast to disguise the hard red wheat flour I started out with initially, before learning about the hard white berries, we were having amazing bathroom results that I would have never dreamt of in a million years. Now I just have to find the perfect combination of flours to start out with so I can get her to eat it without having to make it into french toast everyday.
02-04-2013, 12:59 AM   #12
kiny
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Fiber for constipation is one of those a myths that people keep repeating. It does not seem to help in people who have slow transit time, there was a whole stuy about it by Voderholze from Germany if you want to look it up. It only helped in a small number of people, and in many people it significantly made the constipation worse, which sounds right to me because fiber in someone with stricturing is going to make matters much worse because it's a bulking agent. Adding fiber in someone who has no stricturing or inflammatory wall thickening isn't going to cause issues, but if you add bulking agents to someone who has crohn's disease with stricturing you are just going to cause blockage.
02-04-2013, 01:05 AM   #13
kiny
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Here is the study, 80 percent of the people with slow transit, which would include people with crohn's disease, did not improve, in fact some worsened if you read the full study. http://www.ncbi.nlm.nih.gov/pubmed/8995945 Fiber is a bulking agent, I don't know what else it would do in people with stricturing than worsen the situation.

Also, you're going to create proximal dilation in front of the stricture because you're bulking the food, you're giving it weight and mass it doesn't used to have, which is fine in people without stricturing, but if the cause of the constipation is stricturing you're going to cause a big mass amount of food in front of the stricture every time, which is how people get proximal dilation and blockage. People are put on EN here when they have stricturing just because of it's non existent fiber content which avoids dilation.


Ill show what proximal dilation is.

Above is a normal stricture, food low in bulking and residue has passed through it without issues, no pressure has been applied to the stricture.

Below is a stricture with proximal dilation, bulking of the food and residue has caused pressure on the intestinal wall in front of the stricture, which sometimes results in total blockage.


Last edited by kiny; 02-04-2013 at 01:25 AM.
02-04-2013, 01:22 AM   #14
Patricia56
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Before and after his diagnosis, my son was treated for severe constipation. Turned out that severe constipation was a major symptom of crohn's for him. His constipation did not resolve until he was in full remission on Humira and 6-MP.

So, in any child with 1st degree relative with IBD, I would be highly suspicious of chronic constipation and want to have some screening labwork done to make sure there wasn't any reason to suspect Crohns. I would also be keeping a close eye on their growth chart.

All that said, the things that the world famous pediatric constipation expert who saw my son for his constipation (post-diagnosis) gave us a list. It's been a couple years but I recall the following things from his list - some of which were surprising:

8 oz juice daily of one of these:
Apple
Pear
Apricot Nectar
Prune

Foods - raw or cooked at least one serving daily:
Pears, (preferably with skin on)
Cherries
Apricots

Avoid:
Applesauce
low fiber breads/pastas
carrots
bananas
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02-04-2013, 01:26 AM   #15
Patricia56
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And the toilet sitting routine is really important he said.

Natural peristalsis or movement of the bowels means that in most people about 20 minutes after eating you will need to go.

So he recommended that my son sit on the toilet after he ate (every time, meals or snacks) beginning within 10 minutes of finishing a meal and staying for at least 15 minutes. Even if he didn't have a BM it was important to establish the routine and expectation that he would need to use the bathroom after meals.

With a 7 year old you might want to find a special toy, book or activitiy that they can do while on the toilet and that they ONLY get to do when they're on the toilet.
02-05-2013, 09:26 AM   #16
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The only problem we had with fiber supplements is getting the water intake right. If they don't drink the amount of water needed right away it can have the opposite effect. We now use fiber supplements to bulk, I have done a complete 180 over here. A good thing to do is serve 1oz of prune juice with every meal and titrate up as needed. I even warm it up in the microwave. Something about warm liquids really help. Fiber from grains never helped my DD with her constipation we used fiber from fruits and veggies to be more effective. Best of luck to you.

Last edited by QueenGothel; 02-07-2013 at 09:39 AM.
02-05-2013, 03:32 PM   #17
Momto2girls
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Yes, we were told no benefiber as well. We originally added it and apparently it almost works against the miralax, which is pulling in the water, and the fiber which is bulking it up? So we don't do Benefiber now and we do 1/2-1 capful of miralax. NOT that it is working for us, either!

We also avoid bananas, add in prune juice, etc.
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02-06-2013, 11:15 AM   #18
CarolinAlaska
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When my kids get constipated (especially my oldest), we've found that going gluten-free is helpful. My crohnie gets diarrhea with gluten, but my oldest gets stopped up. Go figure. It is worth the try if constipation is a chronic problem, especially if anyone else in the family is gluten-intolerant.
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02-06-2013, 11:24 AM   #19
QueenGothel
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CA my kid was the opposite. GF bulked her up. I think the importance is to not replace with boxed GF items. (Replacing Gluten with soy, rice, corn) Avoiding processed food in general is a good rule of thumb, by doing this it pretty much makes for a GF lifestyle and a healthier lifestyle.
02-06-2013, 08:53 PM   #20
Farmwife
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Yes I'm with the Queen on this one. Grace isn't normal and all the things that should help her don't. She was on 3 half a day, Even on EN. She's still needing miralax.
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02-07-2013, 01:20 AM   #21
CarolinAlaska
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On 3? I don't quite understand your sentence, can you clarify?

I just brought up the gluten to say that for us who are gluten sensitive, it can cause both diarrhea and constipation, for what it's worth, and cutting it from our diet made a world of difference. Jae and I have to do it, my other two girls get it by default of living with GF folks and we found it helped with the constipation . I'm not saying it will help everyone, but if it helps someone...
02-07-2013, 09:37 AM   #22
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I believe FW mean 3 doses of Miralax. I just wanted to point out that for most GF is more bulking bc of the rice and corn mostly replacing Gluten. I know this for most j-pouchers (colon-less) use this diet to thicken their stools up being they don't have the colon to remove the water. With my DD it made her some symptoms better but it made her stools extremely hard to pass, this was actually when the rectal prolapse started to happen. Eek! I just wanted to point out to watch out for bulking, bc though it might help with one, it might make things much worse also. GF without processed foods is great. But GF bread and pastas can be rough. My kid is big on bread and pasta. We are finally able to eat these things now and again.
02-07-2013, 09:51 AM   #23
QueenGothel
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Paso buff, I posted and didn't really suggest anything. Sorry! There are certain tricks along the way I have found to be very helpful beyond the grape juice and Miralax. Another is dark chocolate, they think they are getting a treat but it is somewhat of a natural laxative and has antioxidants. Berries are good for this too we freeze blueberries and that is a treat also. I've use prune juice, and anything warm and liquid like broth. When I do make pasta extra (non cream) sauce on everything! Asparagus soup is tasty on pasta. Never had an issue with yogurt I used it in place of milk as a thickener but make sure the sauce isn't hot or it will curdle. (Nasty) fish oil helps and I use to use aloe Vera juice too but SCD says no but it defiantly helped with constipation.

When constipated avoid milk, bananas, potatoes, and apples, mashmallows, bread, Nut butters.
02-07-2013, 09:55 AM   #24
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Ya sorry. She was on three half cupfuls of miralax a day! Plus senakot (sp?) every other day.
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Crohn's Disease Forum » Parents of Kids with IBD » Diet/Cooking for Kids with IBD » Anti-constipation diet.....(non-crohns)
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