What causes chronic constipation in children? 

By Beth Sissons; Medically reviewed by Karen Gill, M.D. 

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.

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. If your child suffers from chronic constipation, see their pediatric health care provider right away.

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

DiagnosisA doctor may first assess symptoms and take a medical history to diagnose chronic constipation in a child. Be observant and keep a record of your child’s bowel movements. The doctor 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 one, or a variety of these tests: digital rectal examination, abdominal X-ray, barium enema, anorectal manometry, rectal biopsy, sigmoidoscopy, colorectal transit study, colonoscopy, laboratory testing.

Treatment and preventionThe 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.

In summary, 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.

Source: https://www.medicalnewstoday.com/articles/chronic-constipation-in-children?

Use if you have room

SIDEBAR:

13 home remedies for constipation

By Helen West; Medically reviewed by Jared Meacham, Ph.D., RD, PMP, MBA, CSCS 

Constipation is uncomfortable and has a number of potential underlying causes. However, many home remedies and natural methods can help.

If constipation persists, a person can talk to their doctor to identify the cause and find an effective treatment.

That said, many of the natural home remedies in this sidebar can provide significant relief.

1. Drink more water
Dehydration can cause constipation, so be sure to drink enough water. Sparkling water (never sugary soda) may be effective at relieving constipation.

2. Eat more fiber, especially soluble, non-fermentable fiber

Try eating more high fiber foods. Supplementing the diet with soluble non-fermentable fiber, such as psyllium, can also help.

3. Exercise more

Try doing some gentle exercise — such as going for regular walks, swimming, cycling, or jogging — to see if it helps.

4. Adults— drink coffee, especially caffeinated coffee

Coffee can help relieve constipation by stimulating the muscles in the gut. It may also contain small amounts of soluble fiber.

5. Take Senna, an herbal laxative

The herbal laxative Senna is a popular remedy for constipation. It stimulates the nerves in the gut to speed up bowel movements.

6. Eat probiotic foods or take probiotic supplements

Probiotics may help treat chronic constipation. 

7. Over-the-counter or prescription laxatives

Laxatives are effective for relieving constipation. Speak to a doctor or pharmacist about the best ones to use.

8. Try a low FODMAP diet

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. A low FODMAP diet may help relieve IBS-related constipation. However, that alone may not provide sufficient relief.

9. Eat shirataki noodles or take a glucomannan supplement

Glucomannan is a type of soluble fiber from the roots of the konjac plant. Some research suggests that it is effective against constipation in some people. Sources include supplements and shirataki noodles.

10. Eat prebiotic foods

Prebiotics are an indigestible carbohydrate fiber. Prebiotics include oligosaccharide and inulin. Although dietary fibers reduce constipation by improving the consistency and bulk of stool, prebiotics have their effects by improving digestive health.
Prebiotic foods include: chicory, Jerusalem artichokes, garlic, onionsbananas, leeks, chickpeas  However, garlic and onions are not included in a low FODMAP diet as these foods can trigger symptoms in people with IBS.

11. Try magnesium citrate
Magnesium citrate is a popular home remedy against constipation. It is a type of osmotic laxative that people can buy over the counter or online.

12. Eat prunes

Prunes contain the sugar alcohol sorbitol, which has a laxative effect. Prunes can be a very effective remedy for constipation. However, people with IBS may want to avoid prunes, because sugar alcohols are high FODMAP foods.

13. Try avoiding dairy

Dairy or lactose intolerance may cause constipation in some people. In these people, removing dairy from the diet can help relieve symptoms.

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