What is constipation in children?

Children who are constipated have fewer than two bowel movements in a week. When they do have a bowel movement, the stools are hard, dry, small, and difficult or painful to pass.

Which children are affected by constipation?

Up to 10% of children will be constipated at any given time. Other factors include the following:

  • Constipation is slightly more common in boys.
  • Children who have developmental delays, behavioral issues or problems affecting the anus or rectum may suffer from chronic (long-term) constipation.
  • Older children and teens may become constipated if their diet does not include enough high-fiber foods and water.
  • Children who are at toilet training-age may be holding in their stool.

What causes constipation in children?

Children often become constipated because they hold in stool. As a result, the colon absorbs too much fluid and the stool becomes dry and hard to pass. Children may hold in stool because they:

  • Don’t want to stop whatever activity they’re doing, such as playing.
  • Are embarrassed to use a public bathroom.
  • Are worried the bowel movement will be painful.
  • Are nervous about learning to use the bathroom or are not ready developmentally for toilet training.

Other causes of constipation in children include:

  • A low-fiber diet
  • Not getting enough fluids
  • Certain medications, including antacids, anticholinergics for muscle spasms, narcotics for pain, and some treatments for depression
  • Health problems that make the stool move slowly through the colon
  • Problems with the way the gastrointestinal system works
  • Irritable bowel syndrome (the colon muscle tightens quickly)
  • An illness that causes a loss of appetite
  • Stress caused by school or by changes in routine, weather or travel

What are the symptoms of constipation in children?

Symptoms of constipation in children include:

  • Several days without normal bowel movements
  • Painful, hard stools that are difficult to pass
  • Unusual postures and movements, such as standing on tiptoes or appearing to be dancing (caused by trying to hold in a bowel movement)
  • Pain or bloating in the abdomen
  • Soiled underwear caused by leaking from fecal impaction (stool is trapped in the colon). This may look like diarrhea.
  • Urinary incontinence (leaking urine) because stool in the colon is pressing against the bladder
  • Bleeding from the rectum
  • Poor appetite
  • Unusually cranky behavior

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