Persistent constipation in children may be due to a lack of fiber, fluids, or exercise or negative toilet habits. In some cases, medications or health conditions can cause chronic constipation.

Constipation can be a common problem in children, and treatment is often effective.

Developing healthy toilet habits, eating a high-fiber diet, and increasing fluid intake and exercise can help.

In some cases, doctors may prescribe laxatives or enemas.

A child with chronic constipation sitting on the toilet.Share on Pinterest
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Causes of chronic constipation include:

Delaying bowel movements

Constipation in children may occur if a child holds in stools or delays bowel movements. If a stool remains in the colon for too long, the colon absorbs excess fluid from the stool. This makes the stool hard and dry, making bowel movements more difficult.

Reasons a child may avoid or delay making bowel movements include:

  • feeling anxious or stressed around toilet training
  • feeling fearful or embarrassed to use public or unfamiliar bathrooms
  • not wanting to interrupt play by going to the toilet
  • feeling fearful or anxious about uncomfortable or painful bowel movements
  • stressful life events

Side effects of medications

Constipation in children may also be a side effect of certain medications or supplements, such as:

Diet and activity

Constipation in children can be due to certain diets and activity levels, including:

  • a lack of fiber in the diet
  • eating high-fat foods that lack fiber, such as junk foods and fast foods
  • filling up on soft drinks
  • not drinking enough fluids
  • changes in diet, such as when babies switch from breastmilk or formula to solid foods
  • lack of physical activity, as movement helps food pass through the intestines

Underlying conditions

In some cases, an underlying condition may cause constipation, such as:

Symptoms of chronic constipation in children may include:

  • fewer than two bowel movements per week
  • hard, lumpy, or dry stools
  • difficult or painful bowel movements
  • a feeling of incomplete bowel movements
  • making unusual positions or movements to avoid making a bowel movement
  • bloating or swollen abdomen
  • daytime or nighttime wetting
  • stool marks in underwear, which may look like diarrhea

A doctor may first assess symptoms and take a medical history to diagnose chronic constipation in a child. They may ask questions such as:

  • How often does the child have a bowel movement?
  • Do bowel movements feel painful?
  • Is the child toilet training at the moment?
  • What does the child eat?
  • Has the child experienced any stressful events recently?
  • Does the child have stool marks in their underwear?

Most of the time, no other tests are necessary. If a child has chronic constipation and signs of an underlying illness, doctors may recommend the following tests:

  • Digital rectal examination: A doctor will insert a gloved finger into the rectum to feel for any abnormalities.
  • Abdominal X-ray: This can show how much stool is present in the large intestine.
  • Barium enema: A doctor will give a child an enema of barium, which is a liquid to help show organs on an X-ray. A doctor will then take an X-ray to examine the abdominal area for any issues, such as blockages.
  • Anorectal manometry: This tests how strong the anal muscles and nerve reflexes are. It also tests how well a child is able to sense when they need to make a bowel movement.
  • Rectal biopsy: A doctor takes a cell sample from the rectum for laboratory testing to check for any problems.
  • Sigmoidoscopy: A doctor will insert a short, lighted tube into the rectum to blow air into the intestines. The air causes the intestines to swell, making it easier to look for problems.
  • Colorectal transit study: A child will swallow capsules containing markers that show up on an X-ray. Over the next few days, the child will eat a high-fiber diet. A doctor will then use an X-ray to see how the capsules have passed through the colon.
  • Colonoscopy: A doctor will use a thin, flexible tube with a small light and camera at one end and insert it into the rectum and intestines. A colonoscopy helps doctors find any problems and take tissue samples.
  • Laboratory testing: Doctors may also recommend other tests, such as blood or urine tests, to check for underlying conditions, such as celiac disease, thyroid problems, or urinary tract infections.

The following tips may help prevent and treat constipation in children:

  • Ensure adequate fiber in the diet through high-fiber foods such as fruits, vegetables, legumes, and whole grains.
  • Increase fluid intake.
  • Get regular exercise.
  • Develop a regular toilet routine by encouraging children to use the toilet after meals.
  • Use a reward system, such as stickers, for using the toilet regularly.
  • Stop toilet training until the constipation resolves.

If these techniques are ineffective, a doctor may prescribe laxatives or an enema. If a medication or supplement is causing constipation, a doctor may alter the dosage or recommend an alternative.

Some home remedies can be unsuitable for children, so caregivers should discuss these with a doctor before giving them to a child.

Chronic constipation in children may occur due to diet, lifestyle factors, or unhealthy toilet habits. Increasing fiber and fluid intake, exercising regularly, and developing positive toilet habits may help treat constipation.

People can see a doctor if home remedies are ineffective or if children have any other concerning symptoms. It is important that children only use laxatives or supplements in consultation with their doctor.