What is constipation?
Constipation is a condition in which there are problems with emptying the bowel. Constipated children have stools that are hard and less regular than usual. Constipation is very common, affecting up to 30 per cent of children. In 95 per cent of cases, there is nothing wrong with your child’s body and the condition can be easily treated with no lasting effects.
What are the signs and symptoms?
Children aged under three years usually pass more than one stool a day. Stools may be less frequent for children that are breastfed, but if they are soft your child is not constipated. From about three years onwards, children usually pass one stool per day.
Your child is likely to be constipated if they have:
- large, hard or painful stools
- stools that are less regular than usual.
A constipated child may:
- avoid passing a stool
- seem to hold off passing a stool for as long as possible
- pass small amounts of liquid stool into their underwear (known as fecal incontinence).
The symptoms of constipation can start suddenly, or happen over a period of time.
Children can develop constipation when there is a change to their routine or a significant event in their life (e.g. starting daycare/kindergarten/school, toilet training or the arrival of a new sibling).
Sometimes children that seem to be “straining” to pass a stool are really trying to stop the stool from passing.
How is constipation diagnosed?
Your GP can diagnose constipation by looking at your child and asking you some questions about their toileting. Tests are not required. Very rarely, constipation might be caused by problems with your child’s body. In this case, your doctor will refer your child to a specialist.
What are the signs and symptoms?
- Refusing to go to the toilet.
- Hiding to pass a bowel motion in a private place.
- Hiding soiled clothes in drawers or under the bed.
- Crossing legs, going on tiptoes, going down on hands and knees or leaning against furniture when a bowel motion is due.
- Making faces.
- Clenching buttocks.
- Lying flat on the floor.
It may appear that they are trying to push a bowel movement out but often they will actually be holding it back.
Constipation is mainly treated with medicine (laxatives) and a program to look at your child’s toileting behaviour. Make sure your child has a diet that is high in fibre and fruit (prune or pear juice can be useful), and encourage plenty of fluids.
Laxatives allow stools to pass more easily through the bowel. Your doctor will advise what dosage is required for your child and the number of days they should be taking the laxatives. Your child should keep taking the advised dose for as long as they are having constipation issues. Stopping the medicine too early is the most common reason for the treatment not working.
You can buy laxatives from your local chemist/pharmacy. Laxatives that contain Magcrogol3350 (called Osmolax and Movicol) are the best choice. They are powders that you can mix with your child’s drink. Osmolax does not have any flavor so can be easily hidden in your child’s drink. Movicol has flavour added which may, or may not suit, your child’s tastes.
Other laxatives may contain lactulose (sweet liquid such as Duphalac) or docusate (such as Coloxyl drops often used in children under 3 years of age).
Develop a routine with your child where they sit on the toilet for a few minutes and attempt to pass a stool about 15 minutes after breakfast, lunch (or afternoon tea if your child goes to school). Provide praise or a small reward for doing this. A sticker chart can also be useful to keep track of the progress.
You should not try toilet training your child while they are having problems with constipation.
When to seek medical help
You should see your GP if:
- You notice blood in your child’s stool
- Your child has bad stomach pains
- Your child’s stools become less regular and are hard
- The treatment you have been given by your doctor is not working
Key points to remember
- Constipation is a common problem in childhood and is usually easily fixed with no lasting effects.
- Treatment consists of medicine (laxatives) and developing a toileting routine for your child.
- The medicine should be taken until your child no longer has problem passing a stool.
- Laxatives are not harmful for your child, even if taken for several months.
- See a doctor if your child is having problems passing stools.
- Constipation needs to be managed properly early. Delays in treatment can cause social and emotional problems for your child.
In an emergency, always call 000 immediately. Otherwise, contact your local doctor or visit the emergency department of your nearest hospital. For non-urgent medical advice, call 13 HEALTH (13 43 25 84) to speak to a registered nurse 24 hours a day, seven days a week for the cost of a local call.