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Information from Your Family Doctor
Constipation in Your Child
Am Fam Physician. 2002 Jun 1;65(11):2295-2296.
What is constipation?
Children with constipation may not have “regular” bowel movements. They may have hard stools or pain during bowel movements, or they may be unable to pass stools at all.
Some children normally have one to three bowel movements a day. Other children normally have bowel movements three to four times a week. How many bowel movements your child normally has every day and every week is what is called his or her “regularity.” You need to be concerned if your child is having bowel movements much less often than what is regular for him or her, or if the normal firmness of the stool changes.
What causes constipation in children?
Most often, children get constipated because they do not drink enough fluids or have enough fiber in their diet.
They can also become constipated if they wait too long to go to the bathroom. Sometimes children put off having a bowel movement because they are busy playing or they do not like to use toilets away from home.
The memory of painful bowel movements can make some young children try to avoid going to the bathroom. If constipation begins during toilet training, it can be a sign that parents are putting too much pressure on their child.
Many illnesses can cause constipation in children. Most of these illnesses are rare and usually have many other symptoms.
Why is it important to treat constipation?
Problems can happen if constipation is not treated. The most common problem is pain in the lower tummy area or the rectum. The rectum is the lower part of the large intestine.
If constipation is not treated, the skin around the anus can tear when your child tries to force out large, hard stools. The anus is the opening from the intestines to the outside of the body. Tears in the anus are painful and often bleed.
If children have constipation for a long time, they can get encopresis (say: en-ko-pree-sis). Encopresis is a leaking of stool from the rectum. This happens when a mass of hard stool causes the anus to remain slightly open.
Constipation that goes on for a long time can also cause children to wet their pants. This happens because of pressure on the bladder from a large amount of stool in the rectum. For the same reason, children can have bladder obstruction and get a urinary tract infection.
What can I do to treat my child's constipation?
Teach your child good toilet habits. Help your child develop the habit of sitting on the toilet regularly. Have your child sit on the toilet at about the same time every day. Provide a footstool for the child's comfort. Your child should remain on the toilet for about 10 minutes, even if he or she does not feel the urge to have a bowel movement.
Toilet training should not be forced. Many children do not learn to control their bowels until they are nearly 4 years old.
If your child has constipation, there may be something going on that is causing him or her to resist the urge to have a bowel movement. Ask your child about any problems. For example, your child may be worried about using the toilets at school because there is not enough privacy, there is no toilet paper, or the bathroom is dirty. Then, see if anything can be done to improve these bathroom conditions.
Improve your child's diet. Encourage your child to drink plenty of fluids, especially water.
Adding fiber to your child's diet is also important. Be certain that your child gets:
At least two servings of fruit each day
At least three servings of vegetables each day
Whole-wheat bread instead of white bread
High-fiber cereals like bran cereal, shredded wheat, whole-grain cereal, and oatmeal
When should my child see a doctor?
Take your child to the doctor if good toilet habits and an improved diet do not help. Your doctor might have your child take a medicine called a stool softener. This will help make the stool softer and make it easier to pass.
Take your child to a doctor if there is blood in your child's stools, if there is blood on your child's toilet paper, or if stool keeps leaking from your child's rectum.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2002 by the American Academy of Family Physicians.
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