What Is Constipation in Children?

What Is Constipation in Children?

Constipation in children can be simply defined as ‘passing hard stools infrequently, with straining’ or ‘difficulty with bowel movements lasting at least 2 weeks and causing significant distress to the child’. Constipation is especially common in preschool and school-age children.

Constipation is a common digestive disorder seen in children of all ages. Although the frequency of constipation among children varies across studies, it is reported at a high rate of around 12% on average. Constipation may be caused by an underlying organic condition or be functional, with no underlying organic cause. Functional constipation accounts for 90–95% of all constipation cases in children. Organic constipation, which makes up 5–10% of constipation cases, may develop due to some congenital bowel anomalies; neurological diseases such as cerebral palsy and spinal cord diseases; Hirschsprung disease; endocrine diseases such as hypothyroidism, hypoparathyroidism and diabetes; some metabolic diseases; celiac disease; some kidney diseases; hypercalcemia; anomalies involving the anus and rectum; neuromuscular disorders of the intestines; or the use of certain medications.

Organic constipation is generally resistant to treatment; if the underlying organic cause is corrected, treatment directed at the constipation will be more successful.

Constipation due to an underlying organic cause begins in early infancy, is severe and does not respond well to treatment. Functional constipation, which makes up the vast majority of cases, is most common in childhood during 3 periods:

The period when complementary foods are introduced in infancy

The early childhood period when bowel control is acquired

The start of school

What Are the Symptoms of Constipation in Children?

Symptoms of constipation in children usually appear as various physical and behavioral changes. Constipation means bowel movements becoming less frequent than normal, or defecation becoming a difficult and painful process. Children may not tell their parents that they are constipated. For this reason, it is important for parents to notice their child’s constipation symptoms.

Some symptoms:

Infrequent bowel movements

Hard and dry stools

Straining and pain

Abdominal pain and bloating

Stool soiling (Encopresis)

Blood from the anus

Restlessness

Children may sometimes also experience stool soiling. This occurs when liquid stool leaks out around hard stool. Stool soiling can lead to shame and social isolation in children.

How Does Constipation Develop in Children?

Although fear developing from the experience of painful, hard bowel movements and the behavior of holding back stool are prominent factors in the development of functional constipation, lifestyle factors such as insufficient fiber intake, drinking little water and not being physically active enough may also contribute to the development of constipation.

Psychological factors, particularly stress experienced during toilet training, may contribute to constipation in children.

Some factors that may play a role in the development of constipation in children are:

Insufficient fiber intake

Low water consumption

Lack of physical activity

Changes in toilet habits

Psychological stress and stool-holding behavior

Dietary pattern and diet

Congenital defects

Endocrine/metabolic diseases

How Is Constipation in Children Diagnosed?

Diagnosis is made based on the child’s medical history, symptoms and physical examination. First, bowel habits are assessed, followed by an abdominal examination. In some cases, additional tests may be required:

Abdominal X-ray

Blood tests

Rectal examination

Stool tests

Colonoscopy

Anorectal manometry

Colonic transit time study

X-ray imaging is a quick and painless procedure and is frequently preferred in diagnosing constipation in children.

How Is Constipation in Children Treated?

Treatment of constipation varies depending on the cause and the child’s age. Generally, lifestyle changes, dietary adjustments and, in some cases, medication are used.

Medication: Used when necessary to soften the stool.

Treatment of the underlying cause: For example, conditions such as hypothyroidism or spina bifida.

Increasing fiber intake

Adequate fluid intake

Developing a balanced eating habit

Establishing a regular toilet routine

Treatment and prevention methods include, under physician supervision, eating fiber-rich foods, drinking an adequate amount of water, engaging in regular physical activity and providing age-appropriate toilet training to children.

Frequently Asked Questions

Eating fiber-rich foods is beneficial for constipation in children; whole grains, fruits and vegetables soften the stool and make bowel movements easier. Drinking enough water keeps the stool soft and helps the intestines work regularly. To evaluate constipation in children, a pediatrician is usually consulted. The pediatrician can examine the symptoms and make the necessary treatment recommendations. However, in some cases the pediatrician may refer the child to a pediatric gastroenterology specialist. In children, constipation refers to a condition lasting longer than 15 days, in which bowel movements become less frequent and stools are hard and passed with straining. However, in some cases, passing hard stools with straining may occur for a shorter period. In such cases too, one should not wait a long time, and bowel movements should be facilitated without allowing the stool to harden further. Constipation lasting less than one month is called acute, while constipation lasting longer is called chronic constipation. Both conditions require appropriate treatment, whether with or without medication. For constipated children, under physician supervision, the addition of fiber-rich fruits and vegetables and whole-grain products to their eating habits and an adequate fluid intake should be recommended. The child should avoid a dry diet and should not consume junk food. To evaluate constipation in children, a pediatrician is usually consulted. The pediatrician can examine the symptoms and make the necessary treatment recommendations. However, in some cases the pediatrician may refer the child to specialists such as a gastroenterologist. For constipated children, under physician supervision, the addition of fiber-rich fruits and vegetables and whole-grain products to their eating habits and an adequate fluid intake may be recommended. In addition, foods containing ingredients such as yogurt may support intestinal health. However, since people’s allergic profiles differ, dietary habits should be arranged under physician supervision.

Constipation in children is a health problem that can negatively affect quality of life but can be largely controlled with the right approach. Early diagnosis, proper nutrition and lifestyle changes are very important in the treatment of constipation. If you notice symptoms in your child such as long-lasting bowel problems, abdominal pain, stool soiling or blood from the anus, you should definitely seek the opinion of a specialist.

At Hisar Hospital, in our Pediatric Gastroenterology, Hepatology and Nutrition department, we offer a comprehensive approach to the diagnosis and treatment of digestive system disorders in children. In addition, for solutions regarding the regulation of eating habits, you can also receive support from our Child Health and Diseases unit.

Constipation can sometimes be a symptom of an underlying disease such as celiac disease. A detailed evaluation process is necessary for the accurate diagnosis of such conditions.

If you would like to access accurate information to protect your child’s digestive health and prevent problems such as constipation, you can contact Hisar Hospital’s team of expert physicians and start the most suitable treatment process for your child by booking an appointment online.