Symptoms & Causes of Constipation in Children

What are the symptoms of constipation in children?

If a child is constipated, he or she may have the following symptoms:

Posturing or changing positions

Posturing or changing positions can show that a child is trying to hold in stool or is constipated. When a child postures or changes position, he or she may

  • stand on tiptoes and then rock back on his or her heels
  • clench his or her buttocks muscles
  • do unusual, dancelike movements

Parents or caretakers often mistake these postures as ways to try and have a bowel movement.

Abdominal pain and bloating

A child may feel pain or bloating in his or her abdomen.

Stool in a child’s underwear

If a child delays having a bowel movement, he or she may develop a large amount of stool in the rectum—something health care professionals call a fecal impaction. Some of this stool may leak and soil a child’s underwear. Parents or caretakers often mistake this soiling as a sign of diarrhea.

Urinary incontinence

Stool in a child’s colon can press against his or her bladder. This pressure may cause daytime or nighttime wetting called urinary incontinence.

When should a child with constipation see a doctor?

A child should see a doctor if his or her symptoms of constipation last for more than 2 weeks. You should take a child to see a doctor right away if he or she has one or more of the following symptoms:

  • fever
  • vomiting
  • blood in his or her stool
  • a swollen abdomen
  • weight loss

What causes constipation in children?

Constipation happens when stool stays too long in a child’s colon. Causes of constipation in children may include the following:

Ignoring the urge to have a bowel movement

Children most often get constipated from holding in stool. When a child holds in stool, the colon absorbs too much fluid and his or her stool becomes hard, dry, and difficult to pass.

Children may hold in stool because they

  • are feeling stressed about potty training
  • are embarrassed to use a public bathroom
  • do not want to interrupt playtime
  • are worried about having a painful or an unpleasant bowel movement

Diets low in fiber

Another common cause of constipation in children is a diet with too little fiber. Fiber helps stool stay soft so that it moves smoothly through a child’s colon. Liquids such as water and juice help fiber work better.

Medicines

Some medicines that doctors prescribe to treat other health problems can cause constipation in children. Medicines that can cause constipation in children include

  • antacids—used to neutralize stomach acid—that contain aluminum and calcium
  • anticholinergics—used to treat muscle spasms in the intestines
  • narcotics—used to treat severe pain
  • some medicines used to treat depression

Certain health problems

Certain health problems can make stool move more slowly through a child’s colon, rectum, or anus, causing constipation:

  • Hirschsprung disease—a birth defect in which the large intestine lacks some nerve cells. The signals that tell your muscles to push stool along are missing, so stool stays in the large intestine and causes blockage.
  • obstructions that block part of the lower gastrointestinal (GI) tract
  • tumors or narrowing of the GI tract

Functional GI disorders

Functional GI disorders happen when something changes the way a child’s GI tract works, yet doesn’t cause damage. Functional constipation happens when the muscles in a child’s colon or anus move stool more slowly, and it often happens during one of three times:

  • when infants transition from breast milk to formula or when they start eating solid foods
  • when parents or caretakers are potty training toddlers, and toddlers are learning how to control bowel movements
  • when children start school and avoid using the bathroom at school for bowel movements

Irritable bowel syndrome (IBS) is also a functional GI disorder. Children with IBS can be constipated.

November 2014
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