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CONSTIPATION OR ENCOPRESIS
(In Children)
Encopresis is a term used for constipation (a delay or difficulty in going to the toilet) often associated with soiling. Dietary changes can help your child with this common, but often embarrassing problem.
DIETARY MANAGEMENT OF ENCOPRESIS
- Adequate fibre intake
- Adequate fluid intake
- Regular activity and exercise
1. The Role of Dietary Fibre
Fibre is the undigested part of plant foods. In the bowel, fibre acts like a sponge, absorbing water and increasing the bulk of the faeces. As a result, the faeces become larger, softer and easier to pass. Fibre also stimulates the activity of the bowel making motions more regular and frequent. There needs to be enough fluid in the diet, otherwise the faeces will become hard and more difficult to pass.
High Fibre Foods
Breads and Cereals
- Wholemeal or high-fibre white bread, fruit bread or fruit rolls, white hi-fibre muffins, crumpets.
- Wholemeal crackers eg. Shredded Wheatmeals, Wholemeal Saos.
- White high fibre pasta, wholemeal pasta and brown rice.
- High fibre cereals eg. porridge, Weetbix, Vita-Brits, muesli, Sultana Bran, Just Right, Fruity Bix, Grinners, fruit and nut Weeties.
Important Note : Unprocessed bran should be avoided as it can interfere with the absorption of important nutrients.
Fruit
- Fresh Fruit, especially with skin eg. apple, pear.
- Dried Fruit (sultanas, apricots, prunes, dates etc).
- Prune Juice and pear juice.
Vegetables
- Raw and salad vegetables (with young children be careful as hard foods may cause choking)
- Cooked vegetables (include skins eg. Jacket potato)
Legumes
- Baked Beans
- Lentils, Split Peas, Chickpeas, Soya Beans, Kidney Beans – add to meat dishes, casseroles, soups and salads.
How much fibre is enough?
The amount of fibre a child needs can be calculated by this simple method: Age of Child plus 5g
Example: 6 yr old plus 5g = 11g fibre required
(See the fibre counter below)
2. The Role of Fluid
Fluid helps to soften the faeces making them easier to pass.
Recommended fluid intake is 6 glasses/day, water is the best choice.
3. The Role of Activity
Regular activity helps to exercise the muscles controlling the bowel. Activity helps to ensure regular bowel motions by helping faeces move through the bowel.
Good examples: riding a bike, walking or running, dancing, throwing a frisbee, jumping on a trampoline, swimming, roller blading or skating, soccer, netball.
SAMPLE MEAL PLAN
Make sure your child enjoys a wide variety of foods each day and plenty of fluid.
Breakfast: |
Cereal (see list) and milk
Toast/Bread (wholemeal, multigrain or high fibre white is preferred) with baked beans etc
Fresh Fruit
Glass of milk
|
Morning Tea: |
Fruit (fresh or dried)
Wholegrain crackers/biscuits with cheese
|
Lunch: |
Sandwich including salad, meat/cheese or baked beans
Fruit (fresh or dried)
Tub yoghurt
|
Afternoon Tea: |
Biscuits/Crackers eg shredded wheatmeal
Fruit
Sandwich
Glass of milk
|
Dinner: |
Serve meat/fish/chicken/legumes
Vegetables
Rice/pasta/bread
Fruit and ice cream/yoghurt
|
FIBRE COUNTER
Food |
Serve Size |
Fibre/Serve (g) |
BREADS & CEREALS |
|
|
Wholemeal bread |
30g / 1 slice |
2.0 |
White bread |
28g / 1 slice |
1.0 |
White high-fibre bread |
28g / 1 slice |
1.5 |
Pita bread |
60g |
2.5 |
Fruit bread |
30g / 1 slice |
1.0 |
Weetbix |
30g / 2 biscuits |
3.5 |
Fruity Bix |
10 pieces |
3.6 |
Muesli |
60g / ½ cup |
6.0 |
Sultana Bran |
1/3 cup |
2.9 |
Porridge |
½ cup raw |
4.0 |
Grinners |
1/3 cup |
2.1 |
Just Right |
¼ cup |
2.0 |
Fruit and nut Weeties |
2/3 cup |
2.3 |
Cornflakes |
30g / 1 cup |
0 |
Rice Bubbles |
30g / 1 cup |
0.5 |
White rice |
1 cup cooked |
1.5 |
Brown rice |
1 cup cooked |
3.0 |
White pasta |
1 cup cooked |
3.0 |
Wholemeal pasta |
1 cup cooked |
8.5 |
Shredded Wheatmeal |
2 biscuits |
2.0 |
Milk Arrowroots |
2 biscuits |
0.5 |
Saos |
3 biscuits |
0.5 |
Wholemeal crackers |
6 biscuits |
2.0 |
Rice cakes |
2 cakes |
0.5 |
 |
Food |
Serve Size |
Fibre/Serve (g) |
FRUIT |
|
|
Apple |
1 medium |
3.0 |
Orange |
1 medium |
3.5 |
Banana |
1 small |
2.5 |
Grapes |
100g |
1.0 |
Sultanas |
30g |
1.5 |
Dried apricot |
25g / 6 small |
2.5 |
Canned fruit |
1 cup |
3.5 |
|
Food |
Serve Size |
Fibre/Serve (g) |
VEGETABLES |
|
|
Potato, no skin |
100g |
1.0 |
Potato, skin |
100g |
1.7 |
Carrots, cooked |
½ cup |
3.0 |
Green beans, cooked |
100g |
2.5 |
Pumpkin, cooked |
85g |
1.5 |
Salad |
1 cup |
1-2 |
Baked beans |
220g / ½ can |
10.5 |
Reference: Department of Nutrition and Dietetic, Nambour General Hospital Diet Sheet. |
