Constipation is a common problem in children. Children with constipation have stools (also called poop or bowel movements) that are hard, dry, and difficult or painful to pass. Some children with constipation have infrequent bowel movements. Although constipation can cause discomfort and pain, it is usually temporary. If left untreated, symptoms could get worse.

When is a bowel movement normal?

Bowel patterns vary from child to child, as in adults. What is normal for your child might be different for another child. Most children have a bowel movement 1 or 2 times a day. Other children may go 2 to 3 days or more before having a regular bowel movement.

What are the symptoms of constipation?

The following are some symptoms of constipation:

• Many days without regular bowel movements
• Stool that is difficult to pass or painful to pass
• Abdominal pain, such as stomach pain, cramps, or nausea
• Bleeding from the rectum due to tears called fissures.

Your child can also:

• Having bowel movements that clog the toilet
• Grimacing while passing a bowel movement as if in pain
• Squeezing your butt when you have a bowel movement. Although this behaviour may seem like your child is trying to push the stool out, he may be holding it in because it hurts.

 If your child does not have a bowel movement at least every 2 to 3 days or if it hurts to have a bowel movement, Call or schedule a visit with your child’s doctor.

What is encopresis?

Sometimes a child with severe constipation may have a bowel movement that looks like diarrhoea. When a child retains stool, the stool accumulates and becomes more significant. They can become so large that the rectum is stretched. So the child may not feel the need to go to the bathroom. The stool becomes too large to pass without an enema, laxative, or other treatment.

Sometimes only liquid stools or solid smears can seep into the underwear. This is called encopresis. It can get better, but it takes months. Talk to your child’s doctor about treatment.

What causes constipation?

These are some of the causes of constipation.

Hold stool.

• Your child may not want to have a bowel movement for various reasons.
• Children ages 2 to 5 may want to show that they can decide for themselves.
• Holding back your bowel movements may be your way of being in control. That’s why it’s best not to pressure children into potty training.
• Sometimes kids don’t want to stop playing to go to the bathroom.
• Older children may retain their bowel movements while away from home (such as camping or school), however, they may be afraid or dislike using public restrooms.

Disease. If your child is sick and loses her appetite, a change in her diet can upset her system and cause constipation. Constipation can be a side effect of some medications or result from certain medical conditions, such as hypothyroidism (underactive thyroid gland).

Diet. Not enough fibre or fluid in your child’s diet does not cause constipation. However, not eating enough of the recommended amounts of healthy foods from all five food groups, including foods that are good sources of fibre, can affect your child’s bowel patterns. See the section “How much fibre does my child need?”.

Other changes. Any change in your child’s routine, such as travel, hot weather, or stressful situations, can affect his overall health and how well his bowels work.

How is constipation treated?

Treatment is based on the child’s age and the severity of the problem. Usually, no special tests are needed.

Constipation can get worse if left untreated. The longer the stool stays inside the large intestine (or colon), the larger and drier it becomes. Then it hurts to pass them. This starts a cycle. The child is afraid to defecate and holds it back even more.

For babies

Constipation is not usually a problem in babies. It can become a problem when starting solid foods, and your doctor may suggest dietary changes or prescribe medication to help soften and pass stool. Inability to pass stool in a newborn (less than one month old) can be a severe problem, and you should see your baby’s doctor.

For children and adolescents

child’s doctor may prescribe medicine to soften or pass stool. Do not give your child laxatives unless you ask the doctor. These medicines can be harmful to children if misused.

Once the stool is removed, your child’s doctor may suggest ways you can help your child develop good bowel habits to prevent stool from building up again.

How can help a child develop good bowel habits?

There are some tips to help your child develop good bowel habits.

• Help your child establish a routine for going to the bathroom. Pick a regular time to remind the child to sit on the toilet daily (for example, after breakfast).
• This makes it easier to pass bowel movements.