More About Chronic Constipation in Children

Constipation is when a child has very hard stools, and has fewer bowel movements than he or she normally does. It is a very common GI (gastrointestinal) problem.

Signs that a child has constipation include:

  • Having fewer bowel movements than normal. Constipation is often defined as having fewer than 3 bowel movements a week. The number of bowel movements may be different for each child. But a change in what is normal for your child may mean there is a problem.
  • Passing stool that is hard and sometimes large
  • Having bowel movements that are difficult or painful to push out

Stool gets hard and dry when the large intestine (colon) takes in (absorbs) too much water.

Normally, as food moves through the colon, the colon absorbs water while it makes stool. Muscle movements (contractions) push the stool toward the rectum. When the stool gets to the rectum, most of the water has been soaked up. The stool is now solid.

If your child has constipation, the colon's muscle movements are too slow. This makes the stool move through the colon too slowly. The colon absorbs too much water. The stool gets very hard and dry.

Once a child becomes constipated, the problem can quickly get worse. Hard, dry stools can be painful to push out. So the child may stop using the bathroom because it hurts. Over time, the colon will not be able to sense that stool is there.

There are many reasons why a child may become constipated. Some common diet and lifestyle causes include:

Diet

  • Eating too many foods that are high in fat and low in fiber. These include fast foods, junk foods, and soft drinks.
  • Not drinking enough water and other fluids
  • Having a change in diet. This includes when babies change from breastmilk to formula, or when they start eating solid foods.

Lack of exercise

  • Children who watch a lot of TV and play video games don’t get enough exercise. Exercise helps move digested food through the intestines.

Emotional issues

  • Not wanting to use public bathrooms. Children may then hold in their bowel movements, causing constipation.
  • Going through toilet training. This can be a difficult time for many toddlers.
  • Having power struggles with parents. Toddlers may hold in their bowel movements on purpose.
  • Feeling stressed because of school, friends, or family

Busy children

  • Some children don’t pay attention to signals that their body gives them to have a bowel movement. This can happen when children are too busy playing. They forget to go to the bathroom.
  • Constipation can also be a problem when starting a new school year. Children can’t go to the bathroom whenever they feel the need. They have to change their bowel routine.

Underlying physical problem

 In rare cases, constipation can be caused by a larger physical problem. These physical issues can include:

  • Problems of the intestinal tract, rectum, or anus
  • Nervous system problems, such as cerebral palsy
  • Endocrine problems, such as hypothyroidism
  • Certain medicines, such as iron supplements, some antidepressants, and narcotics such as codeine

Symptoms can occur a bit differently in each child. They may include:

  • Not having a bowel movement for a few days
  • Passing hard, dry stools
  • Having belly (abdominal) bloating, cramps, or pain
  • Not feeling hungry
  • Showing signs of trying to hold stool in, such as clenching teeth, crossing legs, squeezing buttocks together, turning red in the face
  • Small liquid or soft stool marks on a child's underwear

The symptoms of constipation can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.