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Constipation is a problem for some people with osteogenesis imperfecta (OI). Two studies indicate that children and adults with OI Type III and pelvic malformation are more likely to complain of constipation and abdominal pain. Constipation, in medical terms, is a decrease in frequency of stools or bowel movements with hardening of the stool. As a consequence, people with constipation may feel bloated and have gas but find it difficult to pass stools. Because the stool becomes quite hard, passing it may be uncomfortable and lead to further unwillingness to try, especially in infants and young children. Fecal impaction, or clogging of the bowel with hardened stool, can be a serious complication. Treatment of constipation in people with OI is often challenging.
Constipation can be caused by inadequate dietary fiber, lack of exercise, and dehydration. Colon obstruction and illness are additional causes. Some medications, especially painkillers, can cause constipation because they decrease the normal motion and movement of the bowel. Adults with OI and parents of children with OI are encouraged to check with their doctor or pharmacist about side effects and possible drug interactions from their medicines and dietary supplements.
OI may contribute to constipation, especially in people with the short stature and pelvic malformation associated with OI Type III. The colon and bowel may be prevented from functioning normally if the hips and pelvis are narrow or malformed. A specific pelvic malformation, known as acetabular protrusion, can affect some people with OI Type III and cause a predisposition to constipation. Diminished mobility and low levels of physical activity also contribute to constipation.
Dehydration is a well-known factor contributing to constipation. Children with OI who have increased perspiration should be closely monitored so they remain hydrated.
Managing constipation usually involves a combination of approaches. It is essential to determine the extent of the problem and develop a plan to correct it.
Children and adults with OI who become constipated often respond well to diet changes, a change in activity level, and mild home remedies. The primary care doctor should be consulted about the appropriateness of home remedies. A nutritionist or registered dietitian may offer useful suggestions for modifying the diet. If the problem persists, a gastroenterologist may be needed.
Treatment choices for constipation include:
These changes to the diet can help people with constipation:
Strive for a diet that keeps the stool soft. Too much fiber has the secondary effect of creating too much bulk for someone with a connective tissue disorder. This can put pressure on the rectum. This pressure, along with inactivity, too much prolonged sitting, the lax or elastic muscles that a person with OI tends to have in the pelvic floor, and chronic constipation can lead to a more serious problem called rectal prolapse.
Adding exercise and physical activity can help prevent and relieve constipation. Exercise helps move digested food through the intestines. Infants, children, and adults who sit, recline, or use a wheelchair require regular position changes. People should consult with their primary care doctor and physical therapist about beneficial exercises that suit their particular needs and abilities. For example, infants benefit from water play that encourages them to kick. Children and adults can benefit from swimming, walking, or bicycling.
Home remedies may include:
1Brand names included in this publication are provided as examples only, and their inclusion does not mean that these products are endorsed by the National Institutes of Health or any other Government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory.
For some children, regular medication or even a prescription laxative may be necessary. Use of medication, whether prescription or over-the-counter, must be discussed with your doctor. Children on medication need to be carefully monitored. Taking a medication too often can reduce its effectiveness or aggravate negative side effects.
Medications for constipation can include:
Talk with the doctor about all treatment options, including home remedies. Persistent, painful constipation should not be ignored, and a referral to a gastroenterologist may be required.
Staying well hydrated, eating a healthy diet, and increasing exercise can reduce the frequency of constipation in children and adults who have OI.
The National Institutes of Health Osteoporosis and Related Bone Diseases ~
National Resource Center acknowledges the assistance of the Osteogenesis Imperfecta Foundation in the preparation of this publication.
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