A recent study has shown that preschoolers who are picky eaters might be oversensitive to food which contributes to difficult toileting behaviours.

According to the study, which was published in the Journal of Pediatrics, normally developing preschool children with chronic constipation have underlying sensory issues that lead to difficult toileting behaviours. These children are often picky eaters who might be overly sensitive to food textures, tastes, or odours. They also might have an exaggerated response to noises, bright lights, or other sensory stimuli.

"Our study is revolutionary, revealing that chronic constipation in young children accompanies heightened sensory sensitivity," said senior author Dr Mark Fishbein.

"In many cases, chronic constipation might be the first hint that the child also has some sensory issues and could benefit from occupational therapy. Feeding problems due to sensory sensitivities are especially common in these children and they are best addressed when kids are under five before maladaptive behaviours become more entrenched," added Dr Fishbein.

In the study, Dr Fishbein and colleagues assessed the differences in sensory processing patterns in 66 children who are 3-5 years of age with chronic constipation and a matched group of 66 controls. They examined how the children's sensory profiles correlate to atypical toileting behaviours. They determined that children with chronic constipation showed increased responses to sensory stimuli and increased avoidance behaviours.

Heightened oral sensory processing (sensitivity to food textures, tastes or odours) emerged as the most significant factor in predicting the child's tendency to behaviours such as withholding stool or overall bathroom avoidance. "On the surface, the association between oral processing and constipation may not seem intuitive. However, increased sensory sensitivity can create discomfort and lead to avoidance, and we see that response in both food refusal and in the toileting behaviours of children with chronic constipation. Both feeding problems and constipation may develop as a result of sensory processing difficulties," said Dr Fishbein.

"Our study offers an expanded tool kit to clinicians who care for children with chronic constipation. Comprehensive care of these children should include consideration of sensory issues and possible referral to occupational therapy," he added. Recognition of the association between chronic constipation and sensory sensitivity could transform clinical practice, the researchers have observed.