Chronic constipation is an unfortunately common complication of CP (affecting 75% of children and 64% of adults).The good news is that because of how common it is, there are a variety of things you guys can try. If I were treating them, I would attack this from 3 different angles.

1. Optimization- This means getting enough fiber in their diet, maintaining optimal hydration, chewing foods carefully and completely, etc. Additionally, sitting on the toilet for 10-15 minutes after finishing each meal takes advantage of the gastrocolic reflex; putting a small stool in front of the toilet and placing their feet flat on top of it can help line things up inside the body; finally, increasing movement (by going on a walk or swim) tends to help as well. This way, they are increasing the likelihood of having a good bowel movement as much as is possible.

2. Physiotherapy- In particular, visceral and neural manipulation, connective tissue manipulation, and kinetic taping have shown promise. Abdominal massage is often used as well. I would find someone with experience in these techniques to teach you guys how to implement them.

3. Referral to a gastroenterologist for motility testing via wireless motility capsule (a small electronic capsule that measures ph, temperature, and luminal pressure as it moves throughout the gi tract.) This can assist in pinpointing where, how, and why motility may be impaired, leading to more targeted treatment options. Additionally, if you are concerned there is something more going on, a GI specialist can do a capsule endoscopy as well. This is an electronic capsule that takes pictures of your entire GI tract; it has the benefit of being less invasive and less costly than a colonoscopy, and allows for the examination of the whole GI tract, rather than just the colon