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

What are the symptoms of Constipation ?

• Less than three bowel movements a week
• Bowel movements that are hard, dry and difficult to pass
• Pain while having a motion
• Stomach pain
• Swollen abdomen , or bloating
• Traces of liquid or pasty stool in your child’s underwear — a sign that stool is backed up in the rectum
• Blood on the surface of hard stool

What are the causes of Constipation ?

Many factors can contribute to constipation in children, including:

• Withholding : Children with hold bowel movements either due to pain or if they are away from home because they’re uncomfortable using public toilets. Painful bowel movements caused by large, hard stools also may lead to withholding. If it hurts to poop, your child may try to avoid a repeat of the distressing experience.
• Changes in diet : Not enough fiber-rich fruits and vegetables or fluid in your child’s diet may cause constipation. One of the more common times for children to become constipated is when they’re switching from an all-liquid diet to one that includes solid foods.
• Changes in routine : Any changes in your child’s routine — such as travel, hot weather or stress — can affect bowel function. Children are also more likely to experience constipation when they first start school outside of the home.
• Medications : Certain antidepressants and various other drugs can contribute to constipation.
• Cow’s milk allergy : An allergy to cow’s milk or consuming too many dairy products (cheese and cow’s milk) sometimes leads to constipation.
• Family history : Children who have family members who have experienced constipation are more likely to develop constipation. This may be due to shared genetic or environmental factors.
• Medical conditions : In certain conditions like diabetes , hypothyroidism, spina bifida, neurological conditions etc
• Surgical Conditions : Rarely there are some conditions like  structural abnormalities or Hirschsprungs Disease which present as constipation. So its always better to meet a pediatric surgeon if constipation persists and doesn’t respond to home remedies.

What are the complications of Constipation ?

Although constipation in children can be uncomfortable, it usually isn’t serious. If constipation becomes chronic, however, complications may include:

• Painful breaks in the skin around the anus (anal fissures)
• Rectal prolapse, when the rectum comes out of the anus
• Stool withholding
• Avoiding bowel movements because of pain, which causes impacted stool to collect in the colon and rectum and leak out (encopresis)

What can you do to prevent Constipation ?

• High-fiber foods : E.g fruits, vegetables, beans, and whole-grain cereals.
• Drink plenty of fluids : Water is often the best.
• Promote physical activity : Regular physical activity helps stimulate normal bowel function.
• Toilet Training : Regularly set aside time in mornings for your child to use the toilet. If necessary, provide a footstool so that your child is comfortable sitting on the toilet and has enough leverage to release a stool.
• Be Supportive : Reward your child’s efforts, not results.
• Review medications : If your child is taking a medication that causes constipation, ask your doctor about other options.

When to see a doctor ?

Constipation in children usually isn’t serious. However, chronic constipation may lead to complications or signal an underlying condition. Take your child to a doctor if the constipation lasts longer than two weeks or is accompanied by:

• Fever
• Not eating
• Blood in the stool
• Abdominal swelling
• Weight loss
• Pain during bowel movements
• Part of the intestine coming out of the anus (rectal prolapse)

The pediatric surgeon would treat the complications of constipation and evaluate for any specific cause and treat it if there is one. Remember, the sooner the constipation is treated, the better and comfortable it is for your child.

Key Words : Constipation | Colics | Hirschsprung’s Disease | Roughage