SMA Nutrition-related Problems: Constipation

People with spinal muscular atrophy (SMA) have a tendency to experience constipation, or infrequent bowel movements. Because these people have weak muscles in their abdomen, it is more difficult for the body to move food through the digestive system. A low daily intake of fibers and fluids may also worsen constipation.

Constipation can cause abdominal discomfort with distention and bloating, spitting up, bad breath, or vomiting after meals.

Some children with SMA type 1 who depend on their abdominal muscles to breathe may experience a drop in oxygen levels or breathing difficulties with attempting bowel movements.

Can constipation be prevented?

It is important to make sure the daily fiber intake of patients is sufficient. The individual needs of the amount of daily fiber is calculated by adding 5 to the age of a person (for example, a 4-year-old will need 9 grams of fiber every day).

High-fiber foods are recommended for SMA patients. These include whole-grain cereals and breads, and fruit and vegetables such as apples, carrots, celery, and oranges. These can be soft-cooked and mixed into smoothies, batters or shakes. Raw fruits and vegetables are harder to chew and swallow and are not recommended.

How is constipation treated?

Some children respond well when the daily amount of fiber is increased. Fruit juices may also help (prune, pear, apple, or white grape juices).

If constipation persists, some laxatives may be recommended, depending on the child’s muscle strength.

Osmotic laxatives, such as Miralax, lactulose, and Milk of Magnesia work by causing water to be retained in the stool, increasing the number of bowel movements and softening the stool so it is easier to pass.

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