Constipation

What is Constipation?

Constipation is one of the most frequent reasons children are brought to a pediatric office. It is a common cause of abdominal pain in children, while other times it presents with urinary symptoms. Sometimes this issue builds gradually over months and may take many weeks or months to completely resolve, while for others it has a more acute onset. The medical definition of constipation describes a stool that is hard, dry, large, or difficult to pass. Those stools may cause a child to strain, experience pain or even have small amounts of blood in the toilet from a fissure, a small tear in the anus.

 

Some children will have one or two bowel movements daily. Other children may go two or three days between bowel movements but will still pass a soft stool. These children are NOT constipated.

 

Causes

There are multiple causes of constipation including dietary, illness, and behavioral.  If the diet is low in fiber or fluids, a child may get constipated. If a child is ill and has a decrease in appetite or becomes partially dehydrated, he may become constipated. Lastly, some children withhold their stool in order to exhibit control or deal with stress, while others may have a fear of school toilets.  Toddlers and young children especially may feel too busy with playtime to take a toilet break.

 

Treatment

The treatment of constipation is dependant on the child’s age.  Fortunately very

young babies rarely get constipated, especially those who are breastfed. For babies, you

should speak with your health care provider before initiating treatment. Sometimes we will use small amounts of juice, water, or glycerin suppositories.

 

In older children and teens, we usually first recommend increasing water intake and high fiber foods.  Foods that may be helpful include beans, broccoli, apples, pears, and whole grain breads and cereals. After trying dietary changes, if your child is still experiencing stooling issues, we often recommend Miralax, an over the counter stool softener.

 

If the above treatments are unsuccessful, your provider may recommend an enema, but please discuss this with him prior to initiating therapy.

 

Constipation is a common problem that can be painful for children and stressful for caregivers.  Whether gradual or acute onset, fortunately, we have many options to help treat your children.  If as a team we are unable to successfully treat the problem, we may refer you to a specialist known as a pediatric gastroenterologist.