Constipation in Kids

Bowel movements that are difficult for your child to pass because they’re dry, hard, large or small and that occur less than twice a week may be signs of constipation.

Remarkable care for kids

• Treatment focused on better living: Pediatricians at Rush University Children’s Hospital want your kids to feel better so they can live better lives. Their focus is always on curing your child’s condition when possible, managing your child’s symptoms and partnering with you and your child to improve your child’s overall quality of life.
• Partners in care: Pediatricians and pediatric gastroenterologists at Rush will work with your child, you and each other to create a personalized treatment plan for your child’s constipation. This plan may include helping your child make lifestyle and behavioral changes at home, nutritional counseling that focuses on a more fiber-rich diet with plenty of fluids, and over-the-counter or prescription medications.
• Managing simple to complex pediatric GI conditions: Pediatric gastroenterologists at Rush University Children’s Hospital specialize in treating kids with more than just bellyaches. They provide personalized, compassionate care for kids who have a range of GI conditions from chronic constipation to gastroesophageal reflux disease (GERD) and several other complex gastrointestinal issues.
• Team approach to abdominal health: The Program for Abdominal and Pelvic Health at Rush specializes in getting to the root of your child’s constipation. Our diverse team of specialists — which includes pediatric gastroenterologists, physical therapists and other clinicians — work with you and each other to address the issues causing your child’s constipation.
• Care close to home: Pediatric gastroenterologists from Rush University Children’s Hospital are available to see patients at Rush University Medical Center in Chicago, Rush Oak Park Hospital and Rush Copley Medical Center in Aurora.

What is constipation in kids?

Although constipation in children generally does not last long and is not dangerous, it can lead to serious health problems, including the following:

• Anal fissures: Small tears in the anus that can cause bleeding, itching and pain
• Fecal impaction: Hard stool so tightly packed in the large intestine and rectum that it cannot be pushed out
• Rectal prolapse: When the rectum slips and hangs outside of the anus, often caused by straining during bowel movements

If you’re concerned that your child may be struggling with constipation, pediatricians and pediatric gastroenterologists at Rush University Children’s Hospital can help with treatment.

Constipation symptoms

Constipation in children can have the following symptoms:

• Abdominal pain and bloating: Your child feels bloated with a painful abdomen
• Changing positions or posturing: Actions that indicate your child is holding in stool or constipated including clenching buttocks muscles, standing on tiptoes and then rocking back on to the heels or odd, dance-like movements
• Stool in underwear: Large amounts of stool develop in the rectum when a child delays a bowel movement (fecal impaction), which can cause stool to leak and soil underwear
• Urinary incontinence: Stool held in the colon can press against the bladder, which may cause daytime or nighttime wetting

Contact your child’s pediatrician promptly if your child experiences any of these symptoms that last for more than two weeks and are accompanied by the following:

• Blood in the stool
• Fever
• Swollen abdomen
• Vomiting
• Weight loss

Constipation causes

When stool remains in the colon for too long your child becomes constipated. The following factors can cause this to happen:

Low-fiber diets

Diets rich in fiber help your child have regular bowel movements. Fiber is a natural stool softener and allows stool to move smoothly through your child’s colon. To improve how fiber works in your child’s diet, consider adding liquids such as water, fruit and vegetable juices and clear soups.

Your child’s pediatrician can work with you to create a diet plan with the proper amount of fiber to treat your child’s constipation.

If constipation is an issue for your child, you may want to avoid these foods that have little to no fiber:

• Cheese
• Chips
• Fast food
• Ice cream
• Prepared snack foods, such as angel food cake, animal crackers, vanilla wafers and frozen meals
• Processed foods such as hot dogs, some microwavable dinners and pot pies

Your child ignores the urge to have a bowel movement

Constipation in children can happen when your child holds in stool. This causes the colon to absorb excess fluid and the stool then becomes dry, hard and difficult to pass.

Reasons your child may hold in stool include:

• Embarrassment about using a public bathroom
• Feeling stressed about potty-training
• Not wanting to interrupt playtime
• Worrying about having an unpleasant or painful bowel movement

Medication

Sometimes medications used to treat other health conditions can cause constipation in children. Some that can cause constipation include the following:

• Antidepressants
• Antacids
• Anticholinergics (used to treat muscle spasms in the intestines)
• Narcotics (used to treat severe pain)

Functional GI disorders

A functional GI disorder happens when something alters how your child’s GI tract works without causing it damage, such as with irritable bowel syndrome (a group of symptoms that cause pain and changes in your child’s bowel movements). As a result, your child experiences functional constipation where the colon or anus muscles move stool slower than normal. Functional constipation can occur during one of the following times:

• Transitioning infants to formula from breast milk or when they start solid foods
• Potty-training toddlers when they’re learning how to control bowel movements
• Children starting school and avoiding using the bathroom for bowel movements

Care for constipation at Rush

Diagnosing constipation

Your child’s pediatrician can diagnose constipation by gathering information from the following:

• Taking a medical history: Questions asked about child’s constipation and mainly used to diagnose functional constipation.
• Performing a physical exam: Listening for bowel sounds, checking abdomen for masses, swelling and tenderness. This may also include a rectal exam to detect blood, tenderness or blockage.
• Diagnostic testing, if necessary: This not generally required, unless treatment is not working or if your child’s clinician suspects other specific causes of constipation. Tests could include blood tests and an X-ray of the abdomen to determine that an underlying condition is causing constipation.

Treatment for constipation in children

Generally, you can treat your child with constipation with home treatments, which may include the following:

• Behavioral changes: Encourage your child to go to the bathroom after meals to build a routine, take a break from potty training until constipation stops, use reward system when child goes regularly.
• Diet and nutrition changes: Making sure your child drinks plenty of liquids throughout the day, eats more fruits and veggies and eats more fiber.
• Enemas: In more severe cases, your pediatrician may recommend an enema, which requires flushing water into the anus to help your child pass a stool
• Laxatives: Your pediatrician may recommend laxatives taken either orally or by anus to clean out the bowels and help your child have a bowel movement.

If your child is not responding to treatment at home and constipation continues, your pediatrician or pediatric gastroenterologist will work with you and your child to address additional issues.