Everyone poops. Now that that’s out of the way, let’s talk about it.
Dr. Lusine Ambartsumyan, director of Seattle Children’s Gastrointestinal Motility program, is on a mission to open up a dialogue about poop.
According to Ambartsumyan, people tend to shy away from conversations related to bowel movements. She says many people feel uncomfortable or shameful talking about it, but these are vital conversations for parents and children to have together.
Millions of children around the world have problems with constipation and fecal incontinence, or the ability to control bowel movements. However, these issues can be difficult to diagnose if children and parents aren’t willing to speak up.
“There’s a stigma, and sometimes parents don’t know their child is suffering from constipation or incontinence because they feel ashamed to talk about it,” said Ambartsumyan. “We have to desensitize and demystify shame around poop. I talk about poop all day long, every single day, and I love talking about it. I want people to feel comfortable talking about it too because it’s critical for their health.”
According to a study released in The American Journal of Gastroenterology, the number of people visiting emergency rooms for constipation is on the rise. Constipation affects an estimated 12% to 19% of the U.S. population, and of that group, infants and the elderly were most likely to be seen in the emergency room. Not talking about bowel movements – how frequently a child goes, if it’s painful, or fears related to toilets – can lead to health and quality of life issues, including constipation and incontinence.
Simply take a look at Ambartsumyan’s office and it’s clear she’s very comfortable with the topic.
Most doctor’s offices are adorned with certificates from prestigious universities. Ambartsumyan’s office is a shrine to poop. She has everything from books about poop, including the popular “Everyone Poops,” to chocolate covered poop candies, stuffed poop emoji pillows and vintage enema bags.
Every day, Ambartsumyan surrounds herself with poop for a very good reason. It helps make the topic more approachable.
Don’t be ashamed, let’s talk about it
Typically, fecal incontinence is caused by constipation. While fecal incontinence can occur in children because of a health condition, Ambarstumyan said the two issues usually go hand in hand. When stool builds up, this may lead children to involuntarily have a bowel movement.
“Think of it like a bucket,” said Ambartsumyan. “If a child doesn’t poop for an extended period of time, that stool will build up causing it to overflow. We essentially need to help children empty their bucket. A school-age child should not be having accidents or wearing diapers. If they are, we can work together to diagnose and fix the problem.”
According to Ambartsumyan, if incontinence and constipation are not treated early on, children can continue to have issues into adolescence and adulthood. Ambartsumyan sees patients in her clinic at Seattle Children’s who are 20 years old and still wearing diapers. She wants people to know, “we can help.”
“We see some patients who are at the end of the line,” said Ambartsumyan. “They’ve exhausted other options, are ashamed, or suffer the social stigma and psychosocial impact of fecal incontinence such as bullying, anxiety, and depression. No one should have to live like that.”
Taking shame out of toilet time
Ambartsumyan advises parents to make toilet time fun and to talk about bowel movements with children – the consistency, the color and the amount. Make the conversation approachable and encourage toilet time by giving rewards for bowel movements.
“Parents buy flavored toothpastes and toothbrushes with cartoon caricatures on them for their children. We need to make potty time a similarly fun and interactive experience,” said Ambartsumyan. “Have kids sit on the toilet and watch television, or or make it a family activity with a parent sitting on the standard toilet and the toddler sitting on their potty chair nearby. Toilets can be loud, wobbly and tall for kids. It’s normal for children to have hesitations, which is why making the experience fun can help.”
Children of all ages typically pass stool between three times daily to once every two days. A child should not hold stool for more than three days. If there are any concerns regarding a child’s stooling habits, parents are encouraged to contact a primary care doctor.
“In clinic, I see severe cases of constipation and fecal incontinence,” said Ambartsumyan. “Most cases are very treatable with behavioral modification and medication. The most important thing to remember is we can help and we welcome the opportunity to talk about poop in order to improve a child’s quality of life.”
For more information about constipation, visit our constipation webpage.