Constipation in Children
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What is constipation?
Constipation is a condition in which bowel movements occur less frequently than usual or stools tend to be hard, dry, and difficult and painful to pass.
Constipation is common in children and is usually without long-term consequences; however, it can diminish a child’s quality of life, cause emotional problems, and create family stress. Rarely, constipation is a sign of a more serious health problem.
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What causes constipation in children?
Children often develop constipation as a result of stool withholding. They may withhold
stool because they are stressed about potty training, are embarrassed to use a public bathroom, do not want to interrupt playtime, or are fearful of having a painful or unpleasant bowel movement.
The gastrointestinal tract.
Delaying a bowel movement causes stool to become hard, dry, and difficult to pass—sometimes resulting in a large mass of stool in the rectum called a fecal impaction. Stool builds up behind the impaction and may unexpectedly leak, soiling a child’s underwear. Parents often mistake this soiling
as a sign of diarrhea.
Other causes of constipation in children include
- a low-fiber diet
- certain medications or drugs, such as antacids, opiates, and antidepressants
- diseases, such as Hirschsprung disease, diabetes, and Down syndrome
- anatomic abnormalities, such as a birth defect
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What are the symptoms of constipation in children?
Symptoms of constipation in children include
- fewer bowel movements than usual.
- postures that indicate the child is withholding stool, such as standing on tiptoes and then rocking back on the heels of the feet, clenching buttocks muscles, and other unusual dancelike behaviors. Parents often mistake such postures as attempts to “push.”
- abdominal pain and cramping.
- painful or difficult bowel movements.
- hard, dry, or large stools.
- stool in the child’s underwear.
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When should a child with constipation see a doctor?
A child should see a doctor if symptoms of constipation last for more than 2 weeks. A child should see a doctor sooner if the constipation is accompanied by one or more symptoms that may indicate a more serious health problem, including
- fever
- vomiting
- blood in the stool
- a swollen abdomen
- weight loss
- painful cracks in the skin around the anus, called anal fissures
- intestine coming out of the anus, called rectal prolapse
The doctor will ask questions about the child’s history of symptoms and will perform a physical examination. The doctor may perform a rectal exam by inserting a gloved finger into the child’s anus to check for anatomical abnormalities and for the presence of a fecal impaction.
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How is constipation in children treated?
Constipation is treated by changing diet, taking laxatives, and adopting healthy bowel habits. Treatment depends on the child’s age and the severity of the problem. Dietary changes include eating more high-fiber foods, such as whole grains, fruits, and vegetables. Laxatives are frequently used to clear a fecal impaction and sometimes to restore regular bowel movements. A doctor should be consulted before giving a laxative to a child. Parents should encourage their child to spend time on the toilet after meals and when their child shows signs of withholding stool.
A child should be seen again by a doctor if treatment fails or if the child begins to show symptoms that suggest a more serious health problem.
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Points to Remember
- Constipation is a condition in which bowel movements occur less frequently than usual or stools tend to be hard, dry, and difficult and painful to pass.
- Children often develop constipation as a result of stool withholding.
- A child with constipation should see a doctor if symptoms last for more than 2 weeks.
- A child should also see a doctor if constipation is accompanied by symptoms that may indicate a more serious health problem.
- Constipation is treated by changing diet, taking laxatives, and adopting healthy bowel habits.
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Hope through Research
The National Institute of Diabetes and Digestive and Kidney Diseases conducts and supports basic and clinical research into many digestive disorders, including constipation in children.
Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov.
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For More Information
American Academy of Pediatrics
National Headquarters
141 Northwest Point Boulevard
Elk Grove Village, IL 60007–1098
Phone: 847–434–4000
Fax: 847–434–8000
Email: csc@aap.org
Internet: www.aap.org
International Foundation for Functional Gastrointestinal Disorders
P.O. Box 170864
Milwaukee, WI 53217–8076
Phone: 1–888–964–2001 or 414–964–1799
Fax: 414–964–7176
Email: iffgd@iffgd.org
Internet: www.iffgd.org
The National Digestive Diseases Information Clearinghouse collects resource information about digestive diseases for the NIDDK Reference Collection. This database provides titles, abstracts, and availability information for health information and health education resources.
You may view the results of the automatic search on constipation in children. If you wish to perform your own search of the database, go to NIDDK Reference Collection.
This publication may contain information about medications. When prepared, this publication included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1–888–INFO–FDA (463–6332) or visit www.fda.gov. Consult your doctor for more information.
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National Digestive Diseases Information Clearinghouse
2 Information Way
Bethesda, MD 20892–3570
Phone: 1–800–891–5389
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: nddic@info.niddk.nih.gov
Internet: www.digestive.niddk.nih.gov
The National Digestive Diseases Information Clearinghouse (NDDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1980, the Clearinghouse provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. The NDDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases.
Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This publication was originally reviewed by
Carlo Di Lorenzo, M.D., Nationwide Children’s Hospital, Columbus, OH.
This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.
NIH Publication No. 09–4633
October 2008
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