Definition & Facts

What is constipation in children?

Constipation in children is a condition in which your child may have

• fewer than two bowel movements a week
• stools that are hard, dry, or lumpy
• stools that are difficult or painful to pass

Your child also may tell you that he or she feels that not all stool has passed.

Some children have more bowel movements than others, so what’s normal for one child may be different from another child. Also, as children get older, their bowel movement patterns may change. Even an infant’s bowel movements change a lot in the first few weeks and months of life. Learn when to see a doctor for your child’s constipation.

Constipation is not a disease but may be a symptom of another medical problem. In most cases, constipation in children lasts a short time and is not dangerous.

How common is constipation in children?

Constipation is common in children of all ages. Almost 1 of every 20 visits children make to a doctor are because of constipation.¹

What are the complications of constipation in children?

Children who have constipation that lasts for a short time usually don’t have complications. However, avoiding or delaying a bowel movement may lead to

• long-lasting constipation
• painful bowel movements
• bladder control problems
• fecal impaction

Complications of long-lasting constipation, especially in older children, may include

• hemorrhoids
• anal fissures
• rectal prolapse

References

Symptoms & Causes

What are the symptoms of constipation in children?

Symptoms of constipation in children may include your child

• having fewer than two bowel movements a week
• passing stools that are hard, dry, or lumpy
• having stools that are difficult or painful to pass
• telling you that he or she feels that not all stool has passed
• changing positions to avoid or delay having a bowel movement, including
  • standing on tiptoes and then rocking back on his or her heels
  • clenching his or her buttocks
  • doing unusual, dancelike movements
• having a swollen abdomen, or bloating
• having daytime or nighttime wetting
• having stool in his or her underwear that looks like diarrhea

If your child avoids or delays having a bowel movement, he or she may develop a fecal impaction.

When should my child see a doctor?

Your child should see a doctor if his or her symptoms last for more than 2 weeks or do not go away with at-home treatment.

Take your child to a doctor right away if he or she has constipation and any of the following symptoms

• bleeding from his or her rectum
• blood in his or her stool
• bloating
• constant pain in his or her abdomen
• vomiting
• weight loss

What causes constipation in children?

Children most often get constipated from holding in their stool to avoid or delay having a bowel movement. When stool stays too long in the colon, the colon absorbs too much fluid from the stool. Then the stool becomes hard, dry, and difficult to pass. Learn more about the digestive system and how it works.

Your child may delay or avoid a bowel movement because he or she

• feels stressed about potty training
• feels embarrassed to use a public bathroom
• does not want to interrupt playtime
• fears having a painful or an unpleasant bowel movement

Certain medicines

Medicines and dietary supplements that can make constipation in children worse include

• antacids that contain aluminum and calcium
• anticholinergics and antispasmodics
• anticonvulsants—used to prevent seizures
• iron supplements
• narcotic pain medicines
• some medicines used to treat depression

Certain health and nutrition problems

Certain health and nutrition problems can cause constipation in children

• not eating enough fiber
• not drinking enough liquids or dehydration
• Hirschsprung disease
• celiac disease
• disorders that affect your brain and spine, such as spina bifida
• spinal cord or brain injuries
• conditions that affect their metabolism, such as diabetes
• conditions that affect their hormones, such as hypothyroidism
• problems that can block or narrow the colon or rectum, including tumors

Diagnosis

How do doctors find the cause of constipation in children?

Doctors use your child’s medical and family history, a physical exam, or medical tests to diagnose and find the cause of constipation.

Medical and family history

Your child’s doctor is likely to ask questions about lifestyle habits and symptoms, such as

• How often does your child have a bowel movement?
• How long has your child had symptoms?
• What do your child’s stools look like?
• Do your child’s stools have red streaks in them?
• Are there streaks of blood on the toilet paper when he or she wipes?
• What is your child’s daily routine, including potty training, physical activity, and day care?
• What are your child’s eating habits?
• What medicines does he or she take?

You may want to track your child’s bowel movements and what his or her stools look like for several days or weeks before the doctor’s visit. Write down or record the information so you can share it with the doctor.

Physical exam

During a physical exam, a doctor may

• check your child’s blood pressure, temperature, and heart rate
• check for dehydration
• use a stethoscope to listen to sounds in your child’s abdomen
• check your child’s abdomen for
  • swelling
  • tenderness or pain
  • masses, or lumps
• perform a rectal exam

What medical tests do doctors use to find the cause of constipation in children?

Doctors don’t normally need medical tests to diagnose constipation in children. However, in some cases, your child’s doctor may use medical tests to help find the cause of constipation.

Lab tests

Your child’s doctor may look for signs of certain diseases and conditions that may be causing your child’s constipation or are related to your child’s constipation. The doctor may use one or more of the following lab tests.

• Blood tests can show signs of anemia, hypothyroidism, and celiac disease.
• Stool tests can show the presence of blood and signs of infection and inflammation.
• Urine tests can show signs of conditions such as bladder infections, which could be caused by constipation.

Bowel function tests

If your child’s constipation doesn’t improve with nutrition changes, your child’s doctor may use bowel function tests, including colorectal transit studies. These tests help a doctor see how well stool moves through your child’s colon.

Imaging tests

In some cases, your child’s doctor may use imaging tests of your child’s abdomen to look for problems that may be causing his or her constipation. Imaging tests include

• ultrasound
• x-rays
• computed tomography (CT) scan

Read about medical tests that doctors may use to find the cause of constipation in older children.

Other tests

Your child’s doctor may suggest a rectal biopsy. The rectal biopsy is the best test to diagnose or rule out Hirschsprung disease. A rectal biopsy is a procedure that involves taking small pieces of tissue from the rectum and examining them with a microscope. The doctor will look at the tissue for signs of medical problems.

Treatment

In this section:

• How can I treat my child’s constipation?
• How do doctors treat constipation in children?
• How can I treat my child’s constipation complication?
• How do doctors treat the complications of constipation in children?
• How can I prevent my child from becoming constipated?

How can I treat my child’s constipation?

You can most often treat your child’s constipation at home by doing the following:

Change what your child eats and drinks

Changing what your child eats and drinks may make his or her stools softer and easier to pass. To help relieve symptoms, have him or her

• eat more high-fiber foods
• drink plenty of water and other liquids if your child eats more fiber

Read about what your child should eat and drink to help relieve constipation.

Change your child’s behavior

Changing your child’s bowel movement patterns and behaviors may help treat constipation.

• Ask your potty-trained child to use the toilet after meals to build a routine.
• Use a reward system when your child uses the bathroom regularly.
• Take a break from potty training until the constipation stops.

How do doctors treat constipation in children?

Your child’s doctor may recommend giving your child an enema or laxative to help treat his or her constipation. Most laxatives are over-the-counter medicines taken by mouth until your child’s bowel movements are normal. Your child’s doctor may recommend stopping the laxative once your child has better eating and bowel habits. You should not give a child a laxative unless told to do so by a doctor.

If your child is taking an over-the-counter or prescription medicine or supplement that can cause constipation, your child’s doctor may recommend stopping it, changing the dose, or switching to a different one. Talk with your child’s doctor before stopping any medicines.

How can I treat my child’s constipation complication?

Your doctor may recommend treating your child’s hemorrhoids or anal fissures by

• making changes in his or her diet to prevent constipation
• using an over-the-counter enema or laxative suggested by your child’s doctor
• having him or her take warm tub baths to soothe the area

How do doctors treat the complications of constipation in children?

Doctors may be able to treat complications of constipation in children during an office visit. Your child’s doctor may recommend at-home treatments, too.

For a child age 2 or older, your doctor may recommend giving mineral oil. Your child will take the mineral oil by mouth or through an enema.

Your child’s doctor may be able to treat rectal prolapse during an office visit by manually pushing the rectum back through the child’s anus. Helping a child prevent constipation is the best way to prevent rectal prolapse.

How can I prevent my child from becoming constipated?

You can help prevent constipation in your child with the same things that treat constipation

• provide enough fiber in your child’s diet
• have your child drink plenty of water and other liquids
• make having a bowel movement part of your child’s routine

Learn more about how you can help prevent constipation in your child by changing what he or she eats and drinks.

Eating, Diet, & Nutrition

What should my child eat and drink if he or she is constipated?

Have your child eat enough fiber. Have him or her drink plenty of liquids to help the fiber work better.

Fiber

Depending on your child’s age and sex, he or she should get 14 to 31 grams of fiber a day.² Fiber guidelines are not available for infants less than 1 year old. Your child’s doctor can tell you what kinds of foods your infant should eat and whether you can try making changes to his or her formula or breast milk.

Talk with your child’s doctor to plan meals with the right amount of fiber for your family. Be sure to add fiber to your family’s diet a little at a time so everyone gets used to the change.

Good sources of fiber are

• whole grains, such as whole wheat bread and pasta, oatmeal, and bran flake cereals
• legumes, such as lentils, black beans, kidney beans, soybeans, and chickpeas
• fruits, such as berries, apples with the skin on, oranges, and pears
• vegetables, such as carrots, broccoli, green peas, and collard greens
• nuts, such as almonds, peanuts, and pecans

Plenty of water

If your child is dehydrated, have your child drink plenty of water and other liquids, such as naturally sweetened fruit and vegetable juices and clear soups, to help the fiber work better.

Drinking enough water and other liquids also helps avoid dehydration. Staying hydrated is good for a family’s overall health and can help avoid constipation. Ask your child’s doctor how much liquid your child should drink each day based on his or her size, health, activity level, and the climate where your family lives.

What should my child avoid eating or drinking if he or she is constipated?

To help prevent or relieve constipation, your child should avoid foods with little to no fiber, such as

• chips
• fast food
• meat
• prepared foods, such as some frozen meals and snack foods
• processed foods, such as hot dogs or some microwavable dinners

Reference

Clinical Trials

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support basic and clinical research into many diseases and conditions.

What are clinical trials and what role do children play in research?

Clinical trials are research studies involving people of all ages. Clinical trials look at safe and effective new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving quality of life. Research involving children helps scientists

• identify care that is best for a child
• find the best dose of medicines
• find treatments for conditions that only affect children
• treat conditions that behave differently in children
• understand how treatment affects a growing child’s body

Find out more about clinical trials and children.

Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.

What clinical trials are open?

Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.