Constipation in Children – Symptoms and Causes

Overview

Constipation affects many children. It is marked by hard, dry stools or infrequent bowel movements. Several factors can cause this condition, with early potty training and dietary changes being the most common triggers.

The good news is that most childhood constipation cases are temporary.

Simple dietary adjustments can make a significant difference. Adding fiber-rich foods like fruits and vegetables to your child’s diet and ensuring they drink enough water can help resolve constipation naturally.

In some cases, a doctor might recommend laxatives as a treatment option, but this should only be done with medical supervision.

Symptoms

Children with constipation often have fewer than three bowel movements per week. When they do go, the stool is typically hard, dry, and painful to pass. Many children experience stomach pain or discomfort during this time.

Parents might notice:

• Blood on hard stools
• Liquid or pasty stool marks in underwear (indicating backed-up stool in the rectum)
• Avoidance behaviors when the child needs to use the bathroom

Children who fear painful bowel movements often try to hold their stool. This behavior may show up as:

• Crossing legs tightly
• Clenching buttocks
• Twisting the body
• Making unusual facial expressions

These signs indicate the child is actively trying to prevent a bowel movement because they associate it with pain or discomfort.

When to Visit a Healthcare Provider

Most cases of constipation in children resolve on their own. However, you should seek medical attention if your child’s constipation continues for more than two weeks or comes with other symptoms.

Call a doctor if you notice:

• Fever
• Loss of appetite
• Blood in the stool
• Swollen belly
• Weight loss
• Pain when trying to poop
• Rectal prolapse (part of the intestine pushes out through the anus)

These signs might point to a more serious problem that needs medical care.

Causes

Constipation happens when waste moves too slowly through the digestive system, resulting in hard, dry stools that are difficult to pass. Children can experience constipation for several reasons.

Behavioral Factors

Children sometimes hold in their stool on purpose. This might happen because they:

• Are afraid of using the toilet
• Don’t want to stop playing
• Feel uncomfortable using bathrooms outside their home
• Had painful bowel movements in the past

Toilet Training Challenges

Starting toilet training too early can cause problems. Children may resist and deliberately hold on to stool. This power struggle can develop into an involuntary habit that becomes difficult to change.

Dietary Issues

Diet plays a major role in bowel movements. Constipation may develop when:

• Children don’t eat enough fiber-rich fruits and vegetables
• They don’t drink enough fluids
• They transition from liquid to solid foods
• They consume too many dairy products

Routine Disruptions

Children thrive on routine, and changes can affect their bowel habits. Common triggers include:

• Travel
• Hot weather
• Stress
• Starting school

Medical Factors

Several medical factors can contribute to constipation:

• Certain medications, particularly some antidepressants
• Cow’s milk allergy or excessive dairy consumption
• Family history of constipation (genetic or environmental factors)
• Underlying medical conditions (though these are rare)

When children experience ongoing constipation, it can create a difficult cycle. Hard stools cause pain, which leads to more withholding, which then worsens the constipation.

Risk Factors

Children may face a higher chance of constipation if they:

• Get little physical activity
• Consume diets low in fiber
• Don’t drink enough water
• Take certain medications (including some antidepressants)
• Have medical conditions affecting the anus or rectum
• Live with neurological disorders

These factors can slow down bowel movements and make passing stool difficult for children.

Possible Problems

Ongoing constipation in children, while usually not dangerous, can lead to several complications if left untreated.

Children may develop painful cracks in the skin near the anus. These small tears can make bowel movements hurt even more.

Sometimes, the rectum can push out through the anus. This condition is called rectal prolapse and needs medical attention.

Many constipated children begin holding in their stool on purpose to avoid pain. This behavior makes the problem worse as more stool collects in the colon. In severe cases, liquid stool may leak around the blockage, causing accidents in underwear.

Preventing Constipation in Children

Children sometimes struggle with constipation, but several simple strategies can help keep bowel movements regular and comfortable.

High-Fiber Foods

A diet rich in fiber helps form soft, easy-to-pass stool. Include plenty of:

• Fresh fruits (especially apples, pears, and berries)
• Vegetables (broccoli, carrots, and peas)
• Beans and lentils
• Whole grain bread, pasta, and cereals

Children need different amounts of fiber based on age:

• Young Children: about 20 grams daily
• Teen Girls: 29 grams daily
• Teen Boys: 38 grams daily

Introduce fiber gradually to prevent gas and bloating.

Hydration

Water helps soften stool and prevents hardening. Encourage children to drink water throughout the day, especially during warm weather or physical activity.

Physical Activity

Regular movement stimulates the digestive system. Daily active play, sports, or walking helps maintain healthy bowel function.

Toilet Habits

Create a consistent bathroom routine, particularly after meals when the digestive system is most active. A small footstool can help children sit comfortably and push effectively. This position makes bowel movements easier.

Children often ignore bathroom signals when playing. Remind them to listen to their body’s cues and take breaks when needed.

Positive Support

Reward effort rather than results. Small incentives like stickers or special books can encourage toilet-sitting time. Never shame or punish accidents, as this creates anxiety about bathroom use.

Medication Review

Some medications can cause constipation as a side effect. If a child takes medicine regularly and experiences constipation, ask their doctor about alternatives or additional steps to manage this effect.

Consistent application of these strategies helps prevent constipation. It also promotes healthy bathroom habits for children.