Identifying, preventing and treating your child’s constipation

First things first: What is constipation?

Constipation is a very common condition in childhood. About 18% of children in the United States ages 4-17 have what’s known as “functional constipation.”

Constipation is often misunderstood because it doesn’t only refer to a difficulty pooping or an inability to pass bowel movements. Children are also considered to be constipated if they pass fewer than about three bowel movements per week (one every other day).

How do I know if my child is constipated?

Constipation can present in many different ways and looks different from one child to the next. Some of the more common symptoms include:

  • Going more than two days between bowel movements.
  • Passing large or hard bowel movements. Some of the signs that might mean this symptom is present:
    • Children complaining of pain with pooping
    • Excessive straining.
    • Poop that clogs the toilet.
    • Small amounts of blood when wiping.
  • Having stool accidents more than once a week after the age of 4 (in most children) or after being potty trained.
  • Abdominal pain, irritability, belly bloating, decreased appetite and/or excessive amounts of gas.
  • Urinary incontinence, especially if child was previously fully trained.
  • Delays in potty training overnight.

Why is my child constipated?

A large majority of children who are constipated do not have an underlying medical problem that is causing constipation. Some common things that can contribute to constipation are:

  • Poor diet, including not getting enough fiber, becoming dehydrated or consuming too much dairy.
  • Lack of exercise.
  • Social problems, which may include anxiety, change of lifestyle, ADHD/ADD, autism, history of abuse and/or problems with using the bathroom away from home.
  • A family history of constipation.

There are some underlying medical problems that can lead to constipation that are important to rule out in certain situations.  The four problems that can contribute to constipation include:

  • Celiac disease (an allergy to gluten, which includes wheat, barley, rye and some oats.) It is VERY important to rule out celiac disease before gluten is removed from your child’s diet.
  • Thyroid problems.
  • A spinal cord problem.
  • A problem with the actual anatomy of the rectum. (This type of condition is usually diagnosed in infancy.)

How is constipation treated?

To learn more about your child’s digestive needs, talk to their pediatrician or contact OHSU Doernbecher Children’s Hospital at 503-346-0640.

Lifestyle changes: Consider increasing fiber in the diet, staying hydrated and decreasing dairy intake. It is also important to address any stress and behavioral problems that could be impacting your child.

Although the lifestyle changes are important, once children are constipated it generally takes a combination of medications for treatment. The medications used will help to keep the poop soft enough to be able to pass easily and to help the intestines actually move the poop through the intestines.

 

Chelsea Doherty, M.S.N., R.N., C.P.N.P
Instructor of Medicine, Division of Gastroenterology and Hepatology
OHSU Doernbecher Children’s Hospital

 

 

Henry Lin, M.D., M.B.A.
Associate Professor of Pediatrics
Division of Gastroenterology
OHSU Doernbecher Children’s Hospital

 

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