Constipation is defined as:
However, normal stool elimination may consist of having a bowel movement 3 times a day or 3 times a week; it depends on the person. Constipation is one of the most common gastrointestinal complaints, resulting in 2.5 million health care provider visits annually.
Sometimes, there is no identifiable reason for constipation in children. However, some of the causes may include:
Hard stools can irritate or tear the lining of the anus (fissure), making it painful to have a bowel movement. The child may avoid having a bowel movement, which can cause further constipation.
The following are the most common symptoms of constipation. However, each individual may experience symptoms differently. Symptoms may include:
The symptoms of constipation may resemble other conditions or medical problems. Always consult your child's health care provider for a diagnosis.
A health care provider will examine your child and get a complete medical history. Depending on the age of your child, you might be asked questions such as:
Occasionally, in addition to a physical examination, your child's health care provider may want to perform other diagnostic tests to determine if there are any problems. These tests may include:
Do not hesitate to contact your child's health care provider if you have any questions or concerns about your child's bowel habits or patterns. The National Institutes of Health recommends that you talk to your child's health care provider if:
Specific treatment for constipation will be determined by your child's health care provider based on the following:
Your child's age, overall health, and medical history
Extent of the condition
Type of condition
Your child's tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
Treatment may include:
Diet changes. Often, making changes in your child's diet will help constipation. Consider the following suggestions:
Increase the amount of fiber in your child's diet by:
Adding more fruits and vegetables.
Adding more whole grain cereals and breads (check the nutritional labels on food packages for foods that have more fiber).
Whole wheat bread, granola bread, wheat bran muffins, whole grain waffles, popcorn
Bran cereals, shredded wheats, oatmeal, granola, oat bran
100% bran cereal
Beets, broccoli, brussels sprouts, cabbage, carrots, corn, green beans, green peas, acorn and butternut squash, spinach, potato with skin, avocado
Apples with peel, dates, papayas, mangos, nectarines, oranges, pears, kiwis, strawberries, applesauce, raspberries, blackberries, raisins
Cooked prunes, dried figs
Peanut butter, nuts
Baked beans, black-eyed peas, garbanzo beans, lima beans, pinto beans, kidney beans, chili with beans, trail mix
Encourage your child to drink more fluids, especially water.
Limit fast foods and junk foods that are usually high in fats and offer more well-balanced meals and snacks.
Limit drinks with caffeine, such as cola drinks and tea.
Limit whole milk as directed by your health care provider.
Plan to serve your child's meals on a regular schedule. Often, eating a meal will stimulate a bowel movement within 30 minutes to an hour. Serve breakfast early so your child does not have to rush off to school and miss the opportunity to have a bowel movement.
Increase exercise. Increasing the amount of exercise your child gets can also help with constipation. Exercise aids digestion by helping the normal movements the intestines make to push food forward as it is digested. People who do not move around much are often constipated. Encourage your child to go outside and play rather than watch TV or engage in other indoor activities.
Proper bowel habits. Have your child sit on the toilet at least twice a day for at least 10 minutes, preferably shortly after a meal. Make this time pleasant; do not scold or criticize the child if he or she is unable to have a bowel movement. Giving stickers or other small rewards, and making posters that chart your child's progress, can help motivate and encourage him or her.If these methods do not help, or if your health care provider notices other problems, he or she may recommend laxatives, stool softeners, or an enema. These products should ONLY be used with the recommendation of your child's health care provider. DO NOT use them without consulting with your child's health care provider first.
The outlook depends on what type of condition caused the constipation. Those children with diseases of the intestine, such as Hirschsprung's disease, may have chronic problems. However, most of the time, constipation is a temporary situation.
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Children's uses magnetic resonance enterography, a radiation-free imaging scan, to provide more information about Crohn disease and irritable bowel disease.
Children’s National Health System offers a three year fellowship training program in Pediatric Gastroenterology, Hepatology, and Nutrition. Our goal is to prepare fellows to become academic pediatric gastroenterologists.
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