Constipation in Children: Causes, Symptoms, Treatment

It's especially common during stages of change, like starting solid foods, learning to use the toilet, or beginning school. Some children may avoid using the bathroom because they fear pain, which can make the problem worse.

Signs like tummy pain, bloating, irritability, or soiling accidents may also show up. Understanding the signs early helps parents support their child and make bowel movements easier and less stressful.

Causes of Constipation in Children

• Low-fiber diet or insufficient water intake
• Lack of physical activity or prolonged screen time
• Delaying bowel movements due to fear or discomfort
• Changes in routine (e.g., travel, starting school, toilet training)
• Bottle feeding or changes in infant formula
• Emotional stress, fears, or significant family changes
• Use of certain medications like antacids, anticonvulsants, or cold medications

Symptoms of Constipation in Children

• Having fewer than two bowel movements per week.
• Having stools that are hard, lumpy, or dry, or having stools that are painful or difficult to pass,
• Expressing to you that they feel some stools have not yet passed.
• Altering their posture to prevent or delay a bowel movement, such as standing
• on tiptoes and then rocking back on their heels.
• Experiencing a large stomach or bloating
• Having daytime or nighttime wetness
• Having what appears to be diarrheal excrement in their underwear.

When to Visit a doctor?

• Persistence of constipation beyond 8 weeks
• When the child is standing to pass stools or straining significantly to defecate
• Child is afraid to evacuate or cries while passing stools
• Pain or Bleeding while
• passing stools
• 'Ribbon stools' (more likely in a child younger than 1 year)
• Abdominal distension
• with vomiting accompanied by constipation
• Urinary tract symptoms like retention of urine, urine infection or incontinence
• Failure to pass meconium/delay (more than 48 hours after birth in a full-term baby)

Diagnosis and Tests of Constipation in Children

Doctors usually start with a detailed medical history and physical examination. A rectal exam may be done to check stool presence.

• Abdominal X-ray: To assess stool buildup.
• Contrast Enema: To detect structural issues like Hirschsprung's disease.
• Observing signs such as abnormal spine structure, skin markings, or limb deformities may also guide diagnosis in complicated cases of pediatric constipation.

Treatment and Management

Treatment of Constipation in Children

• Dietary Fiber: Green leafy vegetables, fruits, whole grains.
• Hydration: Encourage plenty of water intake.
• Laxative for Kids: Prescribed medications like Lactulose, Polyethylene glycol, Docusate Sodium, Sodium Picosulfate, or Bisacodyl.
• Glycerin suppositories or simple enemas: For impacted stools If no improvement is seen, further evaluation for underlying conditions is essential, and referral to pediatric surgical specialists may be needed.

Prevention Tips for Constipation in Children

• Encourage regular toilet habits.
• Provide fiber-rich meals and healthy snacks.
• Ensure adequate hydration.
• Promote daily physical activity.
• Limit screen time.
• Address emotional stress or changes in routine early.
• Avoid unnecessary use of medications that may cause constipation.

Home Remedies for Constipation in Children

• A sitz bath (sitting in warm water) can relieve pain and relax the area.
• Gentle abdominal massage.
• Use of Isabgol (psyllium husk) with water.
• Applying a warm, moist cloth to the anal area.
• Natural fiber from fruits like prunes, papayas, and apples.

Lifestyle Changes for Constipation in Children

• Establish a toilet routine, especially after meals.
• Avoid forcing toilet training in toddlers.
• Make toilet time relaxing and non-pressuring.
• Encourage outdoor play and reduce sedentary behaviors.
• Track and praise successful bowel movements without punishment.