Pediatric Urology
Managing Constipation
It is important to poop every day, at least once a day. Healthy poop looks like a
long skinny brown banana, or a Bristol 4 on the Bristol Stool Scale Chart. Here
are some of the things that keep the colon healthy and help us poop.
1.Drink enough water. Keep a water bottle at school, and drink the whole
bottle every day by the end of the school day. Keep another one at home for
weekends and holidays. Drinking out of a water bottle gives good feedback
about how much water you consume. The water is in addition to any milk,
juice, or other beverages that day.
a. Ages 3-7 need 1 liter (34 ounces) a day.
b. Ages 8­-11 need 1.5 liters (51 ounces) a day.
c. Ages 12+ need 2 liters (68 ounces) a day.
If it is a hot day, or if you’re doing exercise, you will need to drink more.
2.Eat enough fiber. Avoid white flour, white bread, white rice, and other foods
where the fiber has been processed out. See our high fiber foods handout for
ideas of how to get more fiber in the diet.
3.Eat more fruits and vegetables.
4.Add healthy oils like olive, avocado, canola, or peanut. Oils help move things
along in our intestines.
5.Do a “poop sit” after a meal every day at the same time. Sit on the toilet for
a minimum of 15 minutes, and try to poop. After dinner often works, since
it takes advantage of the natural gastrocolic reflex to move things along in
the colon.
6.Don’t hold it for long. If you feel the need to poop, go and find a bathroom.
Don’t wait until you get home! This sends the wrong signals to the colon,
and will slow things down.
Continued on back
Erin Grantham, MD,
Pediatric Urologist
For an appointment,
call (406) 238-2501 or
1-800-332-7156.
billingsclinic.com/kids
Pediatric Urology
Unfortunately, lots of kids are constipated and are not able to manage it
with diet alone. Over the counter treatments like stool softeners, MiraLAX,
and occasional use of stimulant laxatives is very safe. When using laxatives,
it is important to clean out the colon at the beginning to avoid unexpected
accidents from a large amount of stool being in the colon. One way to do
this is:
1. 1 capful of MiraLAX Friday morning.
2. 1 capful of MiraLAX + 1 chocolate Ex­Lax chew Friday evening.
3. 1 capful of MiraLAX +1 chocolate Ex­Lax chew Saturday morning.
4. 1 capful of MiraLAX +1 chocolate Ex­Lax to Saturday evening.
5. 1 capful of MiraLAX Sunday morning.
6. Maintenance MiraLAX of ½-1 capful daily after that.
In order to know that the colon has been cleared out, the poop should be
coming out like watery diarrhea. On the above regimen, that will usually
happen either on Saturday afternoon, or sometime on Sunday. If your child
gets diarrhea on maintenance MiraLAX, it is important to not stop the
MiraLAX entirely. Instead, reduce the amount that they are getting every day
by half. It is okay to increase and decrease the amount of MiraLAX by small
amounts until you figure out exactly the right amount for your child. It is
also okay to change the time of day. MiraLAX takes between 12 and 24
hours to work. Depending on how long it takes to move through your child’s
colon, giving it in the am, after school, and before bed may work best for
your family.
Erin Grantham, MD,
Pediatric Urologist
For an appointment,
call (406) 238-2501 or
1-800-332-7156.
billingsclinic.com/kids