Obese kids more likely to have bowel problems

Key points
- Obese children appear to be at risk of both constipation and lack of bowel control, new research reports.
- The U.S. investigators found that nearly one-quarter of obese kids between the ages of 1 and 18 are constipated, compared to only 16 percent of 2 year-olds and 3 percent of older children noted in previous reports.
- Moreover, 15 percent of obese kids appeared to have problems with fecal soiling, which typically occurs in only 1 to 3 percent of all children.
- Samuel Nurko said that obese children may be more likely to have bowel problems if they tend to eat less fiber, or if they have problems with their intestines.
Obese children appear to be at risk of both constipation and lack of bowel control, new research reports.
The U.S. investigators found that nearly one-quarter of obese kids between the ages of 1 and 18 are constipated, compared to only 16 percent of 2 year-olds and 3 percent of older children noted in previous reports.
Moreover, 15 percent of obese kids appeared to have problems with fecal soiling, which typically occurs in only 1 to 3 percent of all children.
Study author Dr. Samuel Nurko said that obese children may be more likely to have bowel problems if they tend to eat less fiber, or if they have problems with their intestines. However, no one is really sure why the rate of bowel problems is so much higher in obese kids, he said.
"First we saw there was a big problem. And now we have to find out why," said the researcher, who is based at The Children's Hospital in Boston, Massachusetts.
However, Nurko stressed that obese kids are not causing their bowel problems on purpose, and parents should not blame themselves for what is happening.
"This is not the parents' fault, and this is not the kids' problem," Nurko said.
To investigate whether obese kids have a higher rate of bowel problems, Nurko and his team asked 80 visitors to an obesity clinic between the ages of 1 and 18 about their bowels. They defined constipation as having symptoms - including infrequent stools, straining or painful defecation - at least one-quarter of the time for at least 3 months.
Fecal soiling was defined as finding stool on underwear or pajamas in children over the age of 4 for at least 3 months, the authors note in the Journal of Pediatrics.
In an interview, Nurko explained that many pediatricians are likely unaware that many of their obese patients have bowel problems, since doctors likely focus on the myriad other known health problems associated with obesity, and may simply not ask about bowels.
Likewise, parents may not know their children only go to the bathroom infrequently, and may not notice the soiled laundry, he said.
Constipation and fecal soiling can make life even more difficult for a child already struggling with his or her weight, Nurko noted, but both conditions can be treated.
Consequently, he recommended that parents talk to their obese kids about how often they go to the bathroom, and check the laundry from time to time for signs of fecal soiling. And if they sense their children are having problems, bring them to the doctor, he said.
SOURCE: The Journal of Pediatrics, August 2004.
Written and revised by
Gerald Hurowitz, M.D.
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