Constipation in Children

What is constipation in children?

Constipation in children is quite common and is characterised by infrequent bowel movements or hard stools. It is not a serious condition but has a tendency to persist longer since children tend to control their bowel movements when constipated to escape the pain associated with passing stools. Chronic constipation needs medical attention as it could point to a serious underlying medical condition.

What are its main signs and symptoms?

Symptoms of constipation in children may include:

• Fewer than three bowel movements in a week
• Dry, hard stools which do not pass easily
• Large stools which do not flush easily
• Pain when passing stools
• Stomach pain or cramps
• Blood in the stool
• Traces of dry stool on the underwear of the child

What are its main causes?

Several causes can contribute to constipation, some of which can be easily avoided or addressed:

• A family history of constipation
• Medical conditions or birth defects related to the digestive system
• Intolerance or allergy to certain foods
• Side effects of certain medications
• Changes in diet or routine
• Trouble during toilet training
• Deliberate withholding of stools

How is it diagnosed and treated?

A medical history of the child along with a physical examination is most often sufficient for the diagnosis of constipation in children. Doctors may insert a gloved finger into the anus to check for abnormalities. Stool tests may also be conducted. In severe cases, an X-ray of the abdomen, a rectal biopsy, a marker test or blood tests may also be done.

Changes to diet and lifestyle are the first step in treatment. Plenty of fibre in the diet and consumption of sufficient water help regulate bowel movements. Doctors sometimes prescribe stool softeners to help pass stools more easily. An enema or a laxative is used when there are blockages interfering with the passage of stools. Sometimes, the enema may need to be administered in the hospital if the child is very severely constipated.

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2. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Constipation in infants and children
3. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Constipation and children
4. Merit M Tabbers et al.Constipation in children. BMJ Clin Evid. 2010; 2010: 0303. PMID: 21718570
5. Shaman Rajindrajith et al. Childhood constipation as an emerging public health problem. World J Gastroenterol. 2016 Aug 14; 22(30): 6864–6875. PMID: 27570423