When children become constipated

It is best to recognize as early as possible that your child is constipated and to seek treatment right away.

What is constipation?

Constipation can be defined as:

a decrease in frequency of bowel movements two or less times per week• stools that are hard, dry and shaped like balls pebble-like stools. Even if this occurs daily
stools that are painful and difficult to pass
large stools that can block the toilet with or without soiling underwear.

Symptoms of constipation

painful bowel movements
stomach pain/abdominal distention
rectal bleeding from tears (fissures)
poor appetite
irritability/crankiness
urine problems (recurrent infections, bedwetting).

Common cause of constipation

The most common cause of constipation is functional (not due to an underlying disease). Functional constipation begins when a child has a painful bowel movement.

The child then holds in the next bowel movement because of the pain he/she experienced before. This is known as “holding.”

Possible causes of holding previous painful defecation

toilet training
stressful event
changes in the diet/routine
travel
viral illness/gasto-enteritis
bad diaper rash
starting school/summer camp
suppositories, enemas
ignoring the urge to go for a bowel movement/ because the child is too busy
toilet not available
use of certain medications
sexual abuse.

Signs that your child may be holding a bowel movement

it may look like your child is trying to push, however he/she is probably trying to hold the stool in
hiding in a corner or holding on to furniture
wriggling on the floor/unusual positions
crossing legs
body is stretched and clenched/up toes
dancing back and forth from one leg to another
may clench buttocks
refusal to have a bowel movement
fear of the toilet.

Treatment

There are different forms of treatment from behaviour modification to lifestyle changes to medication.

You should discuss a treatment plan with your child’s physician before trying any home remedies.

This information was prepared by the team in the Motility Lab of
the Pediatric Gastroenterology Service [1] of The Montreal Children’s
Hospital of the McGill University Health Centre.

The Montreal Children’s Hospital
2300 Tupper Street, Montréal (Québec) H3H 1P3
Telephone: 514 412-4400