Bowel Health
Bowel movement, appearance, consistency, frequency and comfort can indicate how well your child is digesting and absorbing their food. It is a good idea to check your child’s bowel movements every now and then and encourage your child to do the same. Bowel motions can be impacted by incorrect enzyme dosing, malabsorption, hydration, illness, medications and mental health.
If your child is experiencing the following symptoms, they should be reviewed by their dietitian:
- Tummy pain, excessive wind and discomfort
- Very bad smelling bowel movements
- Greasy, oily bowel movements
- Diarrhoea (symptoms include increased stool frequency, watery/loose stools and abdominal pain).
- Constipation (symptoms include reduced stool frequency, hard pellet like stools, abdominal pain, pain when passing stool).
- Poor weight gain and/or growth
Bowel management recommendations will vary depending on your child’s symptoms. General bowel health recommendations include adequate fluid and fibre rich foods such as fruits, vegetables and wholegrains.
DIOS
Distal Intestinal Obstruction Syndrome (DIOS) is a complication of CF which occurs when faecal material and intestinal contents stick to the lining of the intestines and cause a partial or complete blockage.
Symptoms
- Cramps
- Abdominal pain
- Bloating
- Constipation
- Loss of appetite and
- Nausea/vomiting
Risk factors for DIOS
Children who were born with a meconium ileus, have had abdominal surgery or have had DIOS previously are at an increased risk of DIOS. Risk factors include:
- Change in diet
- Illness/exacerbation (chest infection)
- Decreased physical activity
- Dehydration
- Inaccurate dosing of enzymes
- Reduced salt and fluid intake
Ways to minimise the risk of DIOS
- Making sure enzymes are matched to the daily fat intake
- Ensuring enough fluids and salt are given to prevent dehydration
- Regular exercise/activity
- Include adequate fibre in their diet (e.g. wholegrain breads and cereals, whole meal pasta, rice, fruit and vegetables)
- Probiotics to restore good gut bacteria
Treatment
DIOS is diagnosed with an abdominal x-ray. Treatment may include rehydration, laxatives and stool softeners. The CF gastroenterologist should be consulted if symptoms recur. In extreme cases, surgical intervention may be required.
Probiotics
Probiotic use in CF continues to be an emerging area in research. Currently, there is no clear evidence as to whether probiotics make little or no difference to pulmonary exacerbation rates, respiratory symptoms and lung function. To optimise gut bacteria, offer a variety of fibre rich foods, and foods that have naturally occurring bacteria such as yoghurt, kefir and other fermented foods. It is highly recommended that you speak to your child’s CF care team before starting them on any new supplements, including probiotics.
Useful Links
- Constipation in Children (PCH)
Downloadable PDF