Constipation

Constipation is a condition in which it is difficult for a person to pass stool.

Constipation generally means passing fewer than three stools a week or having a difficult time passing stool, it is a relatively common condition in the general population. Constipation is considered chronic if an individual has 2 or more of these symptoms for 3 months or longer:

  • Fewer than three stools a week
  • Hard, dry or lumpy stools
  • Straining or pain when passing stools
  • A feeling that not all stool has passed
  • A feeling that the rectum is blocked
  • The need to use a finger to pass stool1

53% of 8p Heroes in the Chromosome 8p Registry report constipation.

While the exact prevalence of constipation in individuals with chromosome 8p rearrangements is unknown, they are recognized as a common symptom. Studies and reports provide a clearer understanding of the prevalence range, though results vary depending on the size and characteristics of the populations studied:

There are many recommendations that can address constipation. The goal is to have a daily, soft bowel movement.

Hydration: Drinking plenty of water is essential for preventing and relieving constipation.

Nutrition: A well-balanced whole foods, high fiber diet to promote regular bowel movements. There are two types of fiber, soluble and insoluble.

  • Soluble fiber dissolves in water, can help lower glucose levels as well as help lower blood cholesterol. Foods high in soluble fiber include: oatmeal, nuts, beans, lentils, pears, apples and berries.
  • Insoluble fiber does not dissolve in water, can help food move through your digestive system, promoting regularity and helping prevent constipation. Foods high in insoluble fiber include: wheat, whole wheat bread, whole grain couscous, brown rice, legumes, carrots, cucumbers and tomatoes.

Daily Movement: Regular movement and exercise is helpful in preventing and relieving constipation.

Natural Stool Softeners
When dealing with constipation, natural stool softeners can be a gentle and effective way to promote regular bowel movements without resorting to laxatives. These remedies work by softening the stool, making it easier to pass.

Important Note: Natural stool softeners are generally safe for occasional use, but it’s essential to start with only one at a time and in small amounts to see how your body reacts. These remedies should complement a balanced fiber-rich diet, adequate hydration, and regular physical activity. If constipation persists, it’s best to consult a healthcare provider to rule out any underlying medical conditions.

Prunes or Prune Juice:
Prunes are a well-known remedy for constipation due to their high fiber content and the presence of sorbitol, a natural sugar alcohol that helps draw water into the intestines, softening stools.

If you’re trying prunes or prune juice for the first time, the general recommendations can be found below:

  • Children:
    • Prune Juice – Start with 2 ounces in the morning. If the body responds well, a second cup in the evening might be helpful.
    • Prunes – About 2.5 dried prunes are equivalent to 2 ounces of prune juice.
  • Adults
    • Prune Juice – Start with 4 ounces in the morning. If the body responds well, a second cup in the evening might be helpful.
    • Prunes – About five dried prunes are equivalent to 4 ounces of prune juice.

MCT Oil:
Medium-chain triglycerides (MCT) are fats that are quickly absorbed and utilized by the body. MCT oil can act as a mild stool softener by lubricating the digestive tract and increasing fat absorption, which can help make stools softer and easier to pass. Start with a small amount (e.g., 1 teaspoon) to avoid potential side effects like cramping or diarrhea.

Magnesium (Citrate or Oxide):

Magnesium is a mineral that plays a key role in muscle relaxation, including the muscles in the digestive tract. Magnesium citrate and magnesium oxide can both help soften stools by drawing water into the intestines, which helps to ease bowel movements. Magnesium supplements can be taken in appropriate doses to support digestive regularity.

Ginger:
Known for its anti-inflammatory properties, ginger can stimulate digestion and help alleviate constipation. It can promote peristalsis and increase bile production, which aids in breaking down food and moving it through the digestive system. Ginger can be consumed as tea, fresh, or in powdered form.

Senna Tea:

Senna is an herbal remedy commonly used for its potent natural laxative effects. It contains compounds called sennosides, which stimulate the intestines to move stool through the digestive tract. Senna tea is best used occasionally and not for long-term relief, as it can cause dependency with prolonged use.

Artichoke Leaf:
Artichoke leaf extract has been used to support digestive health by promoting bile flow, which aids in digestion and helps relieve constipation. It can be consumed as a supplement or brewed as tea to help with bowel regularity.

  1. Mayo Clinic. Constipation: Symptoms and Causes.https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253
    .
  2. Okur, Volkan, Chung, Wendy et al. “Clinical and Genomic Characterization of 8p Cytogenomic Disorders.” Genetics in Medicine, https://project8p.org/wp-content/uploads/2023/08/s41436-021-01270-2.pdf..
  3. TREND Community. Community Voice Report: Chromosome 8p. Vol. 2, Issue 1, September 2023. Available at: https://drive.google.com/file/d/1VhzeMAA1eBi8lUlh2RwTOqm-X7dnCYKg/view.
  4. Harvard T.H. Chan School of Public Health. The Nutrition Source: Fiber..
    https://nutritionsource.hsph.harvard.edu/carbohydrates/fiber/
    .
  5. Cleveland Clinic. Prune Juice for Constipation: Does It Work?
    .
    https://health.clevelandclinic.org/prune-juice-for-constipation

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Project 8p Foundation’s Share What Works Series:

Geri Brewseter RD MPH CDN.
Nutritional Series

Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease GERD is a condition where stomach acid frequently flows back into the esophagus, the tube connecting the stomach to the mouth. It is commonly referred to as acid reflux.

Many people will experience acid reflux, however when it happens repeatedly over time it can cause GERD.

Symptoms of GERD:

  • A burning feeling in the chest, commonly known as heartburn. This sensation often occurs after meals and may worsen at night or when lying down.
  • Regurgitation of food or sour liquid into the throat
  • Pain in the upper abdomen or chest
  • Difficulty swallowing, also known as dysphagia
  • A sensation of a lump in the throat
  •  

For those experiencing acid reflux at night, additional symptoms might include:

  • A persistent cough
  • Inflammation of the vocal cords, known as laryngitis
  • New or worsening asthma symptoms

Spitting up is common for young infants. As long as the child is growing well and not developing other issues, this condition usually requires no treatment and typically resolves with time.

When to Seek Treatment for GERD in Children: Treatment may be necessary for GERD in children if your child has:

  • Frequent vomiting that leads to poor weight gain or stunted growth
  • Pain that interferes with daily activities
  • Complications from reflux, such as esophageal inflammation (esophagitis), ulcers in the esophagus, or respiratory issues that require hospitalization2

25% of 8p Heroes in the Chromosome 8p Registry report Reflux.

Project 8p Foundation Affiliated Research on Chromosome 8p Disorders

While the exact prevalence of GERD in individuals with chromosome 8p rearrangements is not well established, it is recognized as a common symptom. Research provides a clearer picture of the prevalence range, although results can vary based on the size and characteristics of the populations studied.

Diagnosis

Most of the time, no tests are needed to diagnose reflux in children. A discussion of symptoms, medical history, and a physical exam are typically sufficient. If symptoms persist or there is weight loss, doctors may use additional tests, such as:

  • Upper GI Series: X-rays taken after the child drinks barium to rule out anatomical issues.
  • pH Probe and Impedance Studies: Measure stomach acid in the esophagus to assess reflux severity or treatment effectiveness.
  • Endoscopy: Uses a tiny camera to check for inflammation or underlying causes of reflux, usually performed under anesthesia.
  • Esophageal and Gastric Motility Testing: Determines if the GI tract muscles are moving food properly.


Treatment


The primary treatment for reflux involves lifestyle changes and reflux precautions.

For babies, formula can be thickened to reduce the amount of spit up, though this doesn’t decrease the number of reflux episodes. Elevating the baby’s head during and after a feed may also help.

For older children, it’s recommended to avoid caffeine, chocolate, greasy foods, and tomato sauce. They should also avoid eating or drinking two hours before bedtime, and elevating the head of their bed can be beneficial.

Medications that neutralize or reduce stomach acid can be used to heal inflammation caused by reflux. These include:

  • Antacids: Neutralize stomach acid.
  • H2 Blockers: Reduce acid production (e.g., Zantac).
  • Proton Pump Inhibitors (PPIs): Strongly inhibit acid production (e.g., Prilosec).


In severe cases of reflux or when complications arise, surgery may be required. This procedure tightens the muscle at the top of the stomach and is usually done laparoscopically by a pediatric surgeon, allowing for quicker recovery with smaller incisions.

  1. Mayo Clinic. GERD: Symptoms and Causes.
    https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940
  2. Boston Children’s Hospital. Gastroesophageal Reflux Disease (GERD).

    https://www.childrenshospital.org/conditions/gerd

  3. Okur, Volkan, Chung, Wendy et al. “Clinical and Genomic Characterization of 8p Cytogenomic Disorders.” Genetics in Medicine, https://project8p.org/wp-content/uploads/2023/08/s41436-021-01270-2.pdf

  4. Children’s Hospital Colorado. Gastroesophageal Reflux Disease (GERD).
    https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/gastroesophageal-reflux-disease

Project 8p Foundation’s Share What Works Series:
Geri Brewseter RD MPH CDN.
Nutritional Series

Diarrhea

Diarrhea is a condition characterized by the frequent passage of loose or watery stools.

Diarrhea is typically defined as passing loose or watery stools three or more times a day, it is relatively common in the general population. Diarrhea is considered chronic if it persists for four weeks or longer, or occurs intermittently over a long period of time. Chronic diarrhea may be associated with other underlying conditions, and individuals experiencing ongoing symptoms should consult a licensed medical provider.

Symptoms of Diarrhea:

  • Frequent, loose, or watery stool
  • Urgency to have a bowel movement
  • Abdominal cramping or pain
  • Bloating or gas
  • Nausea
  • Dehydration
  •  

Chronic diarrhea may also lead to additional complications, such as nutrient deficiencies or dehydration, requiring more focused treatment and care.

10% of 8p Heroes in the Chromosome 8p Registry report Diarrhea.

While the exact prevalence of Diarrhea in individuals with chromosome 8p rearrangements is not well established, it is recognized as a common symptom. Research provides a clearer picture of the prevalence range, although results can vary based on the size and characteristics of the populations studied.

Treatment

Most cases of sudden diarrhea resolve on their own within a few days. However, if home remedies are ineffective, a licensed medical provider may recommend medications or other treatments.

  • Antibiotics or Antiparasitics: These medications may be prescribed if bacteria or parasites are the cause of diarrhea. Viral diarrhea does not respond to antibiotics.
  • Fluid Replacement: It’s important to replace lost fluids and electrolytes. For most adults, drinking water with electrolytes, juice, or broth is recommended. If fluids are not tolerated, IV fluids may be necessary. Children may benefit from oral rehydration solutions like Pedialyte.
  • Adjusting Medications: If an antibiotic is causing diarrhea, your healthcare provider may adjust the dose or switch medications.
  • Treating Underlying Conditions: If diarrhea is due to a more serious condition, like inflammatory bowel disease, a specialist may develop a treatment plan to manage the underlying condition.
  1. Mayo Clinic. Diarrhea: Symptoms and Causes

    https://www.mayoclinic.org/diseases-conditions/diarrhea/symptoms-causes/syc-20352241
  2. Okur, Volkan, Chung, Wendy et al. “Clinical and Genomic Characterization of 8p Cytogenomic Disorders.” Genetics in Medicine,
    https://project8p.org/wp-content/uploads/2023/08/s41436-021-01270-2.pdf

Project 8p Foundation’s Share What Works Series:
Geri Brewseter RD MPH CDN.
Nutritional Series

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This visualization is powered by research sponsored by Project 8p and survey data collected from the Chromosome 8p Registry, representing insights from a total of 120 8p heroes. It is part of the soon-to-launch Insights Portal, designed to offer advanced tools for data analysis, access, and visualizations, accelerating research and discovery for chromosome 8p disorders.

Add your piece to the puzzle

The Project 8p Foundation (Project 8p) was created in 2018 to:

  • Accelerate future treatments, not only for 8p, but potentially for other chromosome-wide diseases as well.
  • Lead with knowledge from patients. Currently, there is no cure for 8p disorders, nor is there a standard course of treatment.

The Project 8p Foundation (Project 8p) was created in 2018 to:

  • Raise transformative funding for pioneering scientific research into treatments for a complex, rare disease involving 250+ affected genes on the short arm of the 8 th chromosome (8p). Rearrangements of these genes causes significant abnormalities to the entire neurological system, thus all organs and functions of the body– with variance in cognitive functions, gross motor skills, social development and other challenges during infancy, and throughout life;
  • Empower a unified community of 8p patients and their families so they can have meaningful lives today; and
  • Accelerate future treatments, not only for 8p, but potentially for other chromosome-wide diseases as well.