Constipation is a big problem for children with neurological disabilities, but a new study shows that simple dietary changes can help most of them feel better. Researchers looked at 146 children with serious brain or nerve conditions and found that nearly 7 out of 10 had constipation. When doctors increased the amount of fiber and water these children consumed, about 6 out of 10 experienced significant improvement. This is good news because it means many children might not need as many medications, could feel more comfortable, and might have a better quality of life overall.

The Quick Take

  • What they studied: Whether increasing fiber and water intake could help children with serious neurological conditions overcome constipation
  • Who participated: 146 children with neurological disabilities (average age around 11 months to 20 years old) living in a long-stay hospital; 54% were boys, and most had very limited ability to move on their own
  • Key finding: About 58% of children with constipation improved significantly when doctors increased their fiber intake from about one-third of recommended amounts to nearly all of it, and increased water intake slightly. This improvement happened without needing more medications.
  • What it means for you: If your child has a neurological disability and struggles with constipation, dietary changes alone might help before trying stronger medications. However, results vary by child, and you should work with your doctor to find the best approach for your situation.

The Research Details

This was a retrospective study, which means researchers looked back at medical records of children who had already been treated at a hospital. They examined 146 children with neurological disabilities and collected information about their constipation, diet, medications, and how their bodies responded to treatment. The researchers specifically looked at what happened when doctors increased the amount of fiber and water these children received through their feeding tubes or regular meals.

The study tracked important details like how often children had bowel movements, what those movements were like, and how much laxative medicine (if any) they needed. The researchers used statistical analysis to figure out which factors made a difference in whether dietary changes worked.

This research approach is important because it shows real-world results from actual patients rather than just testing ideas in a lab. Children with neurological disabilities often have unique challenges with constipation because their bodies may not move properly, they may have feeding tubes, or they take medications that affect digestion. Understanding what actually works for these specific children helps doctors make better treatment decisions.

This study has some strengths: it looked at a decent-sized group of children (146) and tracked specific details about their bowel movements and diet. However, because it’s a retrospective study looking back at records rather than following children forward over time, it can’t prove that diet changes directly caused the improvement—other factors might have played a role. The study was done in one hospital, so results might be different in other places or with different types of children.

What the Results Show

The researchers found that constipation was very common in this group of children—about 7 out of 10 had it. This is much higher than in typically developing children. When doctors increased fiber intake from about 36% of recommended amounts to 95%, and increased water from 127% to 136% of recommendations, about 58% of the children with constipation showed clear improvement.

The improvement was significant enough that many children needed fewer laxative medications or none at all. This is important because it suggests that for more than half of these children, dietary changes alone could be an effective first step before turning to stronger medications.

The study also found that certain factors made constipation more likely: older children were more at risk, and children who were overweight or obese had higher rates of constipation. Additionally, the way children were fed mattered—those who received food in larger amounts at specific times (called bolus feeding) had better responses to dietary changes than those who received continuous feeding.

The researchers discovered that the type of feeding method was important. Children who received bolus feeding (larger meals at set times) responded better to dietary changes than those on continuous feeding. The study also suggested that having a mixed diet (different types of foods) might help, though this wasn’t quite statistically proven. Most of the children in the study (88%) were fed through gastrostomy tubes (tubes directly into the stomach), which is common for children with severe neurological disabilities.

Previous research on constipation in children with neurological disabilities has been limited, so this study fills an important gap. Most existing information comes from studies of typically developing children or general pediatric populations. This research confirms what doctors suspected—that constipation is much more common in children with neurological disabilities—and provides new evidence that dietary management can be effective for many of them, potentially reducing reliance on medications.

This study has several important limitations to consider. First, it only looked at children in one hospital, so results might be different elsewhere. Second, because researchers looked back at medical records rather than following children forward, they couldn’t control all the factors that might affect results. Third, the study didn’t have a comparison group of children who didn’t receive dietary changes, so we can’t be completely certain the diet changes caused the improvement. Finally, the study didn’t track how long improvements lasted after the dietary changes were made.

The Bottom Line

For children with neurological disabilities who have constipation, dietary management with increased fiber and water should be considered as a first-line treatment before moving to stronger medications. This recommendation has moderate confidence because about 6 out of 10 children improved, but results vary. Work with your child’s healthcare team to gradually increase fiber and water intake, as sudden changes can sometimes cause discomfort. If dietary changes don’t work after 2-4 weeks, discuss medication options with your doctor.

This research is most relevant for parents and caregivers of children with neurological disabilities (such as cerebral palsy, severe developmental delays, or spinal cord injuries) who struggle with constipation. It’s also important for pediatricians, gastroenterologists, and nutritionists who work with these children. Children with typical development and constipation might benefit from similar approaches, but this study specifically focused on children with neurological conditions. If your child has other medical conditions or takes multiple medications, discuss these findings with your doctor before making changes.

Most children in the study showed improvement within a reasonable timeframe, though the exact timeline wasn’t specified in detail. Generally, you should expect to see changes in bowel movement frequency and consistency within 1-2 weeks of increasing fiber and water, though it may take 2-4 weeks to see full benefits. If no improvement occurs after 4 weeks of consistent dietary changes, contact your doctor about other options.

Want to Apply This Research?

  • Track daily bowel movements by recording: (1) frequency (how many times per day), (2) consistency (hard, normal, or soft), and (3) any discomfort or straining. Also log daily fiber intake in grams and water/fluid intake in milliliters to correlate dietary changes with bowel movement improvements.
  • Gradually increase fiber intake by 5 grams per week (to avoid sudden stomach discomfort) while simultaneously increasing water intake by 10% each week. Set daily reminders to ensure consistent fluid intake throughout the day, and track which feeding method (bolus vs. continuous) is being used to identify patterns.
  • Create a weekly summary dashboard showing: (1) average daily bowel movements, (2) consistency patterns, (3) laxative medication use and doses, (4) total daily fiber and water intake, and (5) any symptoms of discomfort. Compare weekly trends over 4-8 weeks to determine if dietary changes are working, and share this data with your healthcare provider at appointments.

This research describes findings from a specific study of children with neurological disabilities in a hospital setting and should not replace professional medical advice. Constipation in children with neurological conditions can have multiple causes and requires individualized evaluation by a healthcare provider. Before making significant changes to your child’s diet, fiber intake, or fluid intake, consult with your pediatrician, gastroenterologist, or nutritionist, especially if your child has feeding tubes, swallowing difficulties, or takes medications that affect digestion. Some children may need additional interventions beyond dietary changes. This information is educational and not a substitute for personalized medical care.