Constipation refers to bowel movements that are infrequent and/or hard to pass. Constipation is a common problem for children.

Most times, there are no exact reasons why children have trouble with constipation. However, some things that might add to your child’s trouble with constipation are:

  • Diet – Some children eat too many foods that are high in fat and low in fiber (“Fast Foods” “Junk Foods” and colas). Also, some children do not drink enough water.
  • Lack of Exercise – Exercise helps move food through the intestines. Children who watch too much TV or play too many video games may not be getting enough exercise.
  • “Busy” Children – Some children are too busy playing and forget to go to the bathroom. They ignore their bodies’ signals that it is time to go sit and have a bowel movement.
  • Emotional Issues – Sometimes children may feel too much pressure to potty train and will resist potty training. Also children might hold back the urge to have a bowel movement because they refuse to use public or even school bathrooms.

Children who are constipated will often hold in their feces and try not to go to the bathroom. Children will tighten their bottoms, cry, scream, hide in corners, cross their legs, shake, get red in the face or dance around to try and hold in their bowel movement. Parents often will confuse these behaviors for trying to pass fecal material when actually children are trying to hold it in.

When your child is having trouble with constipation, he/she may have:

  • A decrease in how often he/she has a bowel movement, may skip days between bowel movements
  • Hard, dry stools
  • Trouble pushing stools out of his/her rectum
  • Pain with bowel movements
  • Abdominal bloating, cramping or pain
  • Small liquid stools or smears of stool in his/her underwear

While it is hard to see your child in pain from constipation, there are other concerns if your child has trouble with constipation for a long time. These concerns include:

  • Hard stools and passing large stools can cause a tear in the anus. This tear is called a fissure. Fissures can bleed and be painful.
  • Straining to have a bowel movement can cause blood vessels (hemorrhoids) inside the child’s anus to become swollen or inflamed and can cause burning pain and bleeding.
  • When a child holds in his/her bowel movement, overtime the feces builds up inside the rectum. This causes the stool to become larger and harder to pass. This can also stretch out the rectum. Runny stool can leak out around this build up of hard, large stool and cause the child to soil his/her underwear. This soiling is called encopresis. Children may not feel this leakage and are often not able to even smell that they have soiled in their underwear. Children may try to hide their underwear when this happens.

Your health care team will talk with you about your child’s specific care plan to treat constipation. This care plan is based on:

  • Cause of the constipation, if one is found
  • Dietary needs
  • Your child’s age, overall health and any special care needs
  • How long your child has had trouble with constipation
  • Your child’s ability to tolerate medications, tests or therapies
  • How long the treatment might take
  • Your feedback on what works best for your child

Children benefit from scheduled toilet breaks, once early in the morning and 30 minutes after meals.

The outlook for treating children with constipation will depend on if there is type of complex problem causing the constipation. Children with diseases of the intestine may have long-term issue with constipation. Up to 90% of children will have no long-term or recurring problems.