Pre-school children with chronic constipation ‘often picky eaters’

They have found that normally developing pre-school children with chronic constipation have underlying sensory issues that contribute to difficulties with toileting behaviours.

“Our study is revolutionary, revealing chronic constipation in young children accompanies heightened sensory sensitivity”

Mark Fishbein

These children were found to often be picky eaters who might be overly sensitive to food textures, tastes, or odours, according to the US authors of a new study.

In addition, such children might also have an exaggerated response to noises, bright lights, or other sensory stimuli, said the researchers in the Journal of Pediatrics.

In the new study, they assessed the differences in sensory processing patterns between 66 children, aged three to five years of age, with chronic constipation and a matched group of 66 controls.

They also examined if and how the children’s sensory profiles correlated to atypical toileting behaviours.

The study authors said they found that children with chronic constipation showed increased responses to sensory stimuli and increased avoidance behaviours.

Heightened oral sensory processing – sensitivity to food textures, tastes or odours – emerged as the most significant factor in predicting the child’s tendency to behaviours such as withholding stool or overall bathroom avoidance, they said.

Senior author Dr Mark Fishbein, from Northwestern University, said: “Our study is revolutionary, revealing that chronic constipation in young children accompanies heightened sensory sensitivity.

“In many cases, chronic constipation might be the first hint that the child also has some sensory issues and could benefit from occupational therapy,” said Dr Fishbein.

“Our study offers an expanded tool kit to clinicians who care for children with chronic constipation”

Mark Fishbein

He said: “Feeding problems due to sensory sensitivities are especially common in these children and they are best addressed when kids are under five, before maladaptive behaviours become more entrenched.”

He noted that the association between oral processing and constipation “may not seem intuitive” but highlighted that increased sensory sensitivity could “create discomfort and lead to avoidance”.

“We see that response in both food refusal and in the toileting behaviours of children with chronic constipation,” he said. “Both feeding problems and constipation may develop as a result of sensory processing difficulties.”

According to Dr Fishbein, recognition of the association between chronic constipation and sensory sensitivity “could transform clinical practice”.

“Our study offers an expanded tool kit to clinicians who care for children with chronic constipation,” he said.

He added: “Comprehensive care of these children should include consideration of sensory issues and possible referral to occupational therapy.”