A seated boy in a plaid shirt holds his head in his hands with a look of discomfort on his face.


Constipation is common in children. In fact, it is estimated to affect five to 30 percent of all children at some point.1 Find out what causes constipation in children and how you can help address it.

In children, constipation is defined as having fewer than two bowel movements per week or having hard, dry and small stools that are difficult or painful to pass. Stool becomes hard and dry because the colon absorbs too much water from the stool when it takes too long to pass through the colon.2

Many of the causes of constipation in children are the same as adults: not eating enough fiber, gastrointestinal disorders, certain illnesses, medication side effects, and ignoring or delaying the urge to pass stool. But more often in children, constipation is the result of life changes, such as transitioning to formula or solid foods, toilet training and starting school.

Children may resist the urge to defecate because they are nervous about toilet training, don’t want to stop playing to use the bathroom, embarrassed to use public toilets or afraid of a painful bowel movement. So they squeeze the muscles around the anus, which then pushes the stool back in the rectum. Over time, this stretches the muscles of the colon and rectum and reduces muscle tone, leading to constipation and more painful bowel movements. This may add to the fear of using the toilet, leading to a painful cycle.

It’s important for parents, teachers and caregivers to watch for the following signs of constipation in children:2, 3

  • Complaints of abdominal pain and cramping.
  • Positions that appear like the child is holding in stool, such as standing or sitting with legs straight, stiff or crossed; clenching his or her buttocks; standing on tiptoes and rocking on heels of feet; hiding in the corner; or becoming red in the face from straining.
  • Stool stains in the child’s underwear. Sometimes, delaying a bowel movement can lead to fecal impaction, which may cause stool to build up in the colon and leak out.
  • Urinary incontinence. If excess stool in the colon presses against the bladder, it can cause wetting in children.

Since every child is unique, it’s important that you and your doctor work together to find a solution that works best for your child. Depending on the cause and severity of your child’s constipation, potential treatments may include:2

Add fluids and fiber to your child’s diet to help maintain regularity. Good fiber-rich foods include fruits, vegetables, legumes and whole grains.

Tell your child why regular bowel movements are important and remind them that they should never be embarrassed or afraid to pass stool. For some children, it may help to encourage them to use the bathroom shortly after a meal or implement a reward system for using the toilet regularly.

If necessary, your doctor may recommend enemas, laxatives or other medication until your child has normal bowel movements consistently. However, you should not try these remedies unless directed to do so by a healthcare professional.

1. National Institute of Health and Care Excellence. Constipation in children and young people: Diagnosis and management of idiopathic childhood constipation in primary and secondary care. May 2010. http://www.nice.org.uk/guidance/CG99. Accessed August 31, 2014.
2. National Institutes of Health. National Digestive Diseases Information Clearing House (NDDIC). Constipation in Children. http://digestive.niddk.nih.gov/ddiseases/pubs/constipationchild/. Accessed August 31, 2014.
3. The University of British Columbia. Learn Pediatrics. Constipation. http://learnpediatrics.com/body-systems/gastrointestinal/constipation/. Accessed August 31, 2014.

Information provided is for general background purposes and is not intended as a substitute for medical diagnosis or treatment by a trained professional. You should always consult your physician about any healthcare questions you may have, especially before trying a new medication, diet, fitness program, or approach to healthcare issues.
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