Constipation in Children

If your child isn’t pooping, or pooping is painful, they may be constipated. Constipation happens to everyone sometimes. But chronic constipation means your child suffers from constipation regularly.

Chronic constipation can be very painful. It can cause patterns of fear and withholding that make the problem worse. It can also be an indication of an underlying problem.

At UVA Health Children’s, many families come to us to help their child with their constipation. In addition to helping them with the immediate problem, we also help to establish what’s causing their constipation. And by finding the cause, we identify ways that we can help them.

Chronic Constipation

Constipation is considered chronic when your child:

• Has fewer than 3 bowel movements per week
• Strains to poop
• Passes hard stools
• Doesn’t poop completely

These symptoms can go on for weeks or months. Routine constipation usually resolves itself, but it also can be treated at home.  

Making sure your child is getting enough fiber, drinking water, and sitting on the potty routinely are often enough to help ease constipation. But if you’re already doing these things, you should talk to your doctor about other options.

Other Chronic Constipation Symptoms:

Other observed symptoms of chronic constipation include:

• Pain during bowel movements

• Stomach pain that gets better after pooping
• Hard, pebble-like stools
• Blood in or on the stool

If the constipation continues, your child may develop encopresis. This causes soiled underwear in-between bowel movements.

Constipation Treatments

Most of the time constipation, even chronic constipation, responds to:

• Diet changes
• Adequate hydration
• Physical activity
• Laxatives
• Enemas

One diet change that helps many children is increasing fiber.  Fiber is an important tool in overcoming constipation, but it can temporarily make symptoms worse.

It's also recommended to change behaviors around toileting. Just having your child sit on the toilet for 5-10 minutes at varying times throughout the day can help.

If diet and behavior changes don’t work, then it's time to talk to your pediatrician. They may recommend medications. If your child’s constipation doesn’t respond to these treatments or isn’t improving overtime, your doctor may send you to our pediatric gastroenterology specialists.

Physical Causes of Chronic Constipation

Rarely, constipation has an underlying physiological cause. Examples of rare, but serious, causes of constipation in children include:

• Hirschsprung's disease — a genetic condition that prevents the colon from working normally
• Thyroid conditions
• Problems with the spinal cord, like spina bifida or tethered spinal cord syndrome
• Malformations of the anus and rectum

Sometimes it can also be caused by issues with food allergies, or intolerances. If we suspect these conditions, we have the equipment and specialists necessary to diagnose and treat these conditions as well.

Diagnosis & Treating Childhood Constipation

Do not use laxatives or other medications without talking to your child’s pediatrician. Most cases of constipation can be treated at home by:

• Drinking plenty of water
• Eating fiber
• Exercise

But if you’re already doing these things and the constipation continues to occur frequently, then you should contact your child’s doctor.

At UVA Health Children’s, we see many children referred for constipation that doesn’t respond to normal treatment. In these cases, we use tests to identify any root causes. Most of the time, constipation is idiopathic, meaning it doesn’t have a clear cause. But that doesn’t mean that it can’t be treated.
We’ll work with your family on trying different methods until we find one that your child responds to.