Is constipation causing my child’s symptoms?

By Dr Jonathan Dudzik

Paediatric gastroenterologist in Ashgrove, Brisbane

Constipation is one of the most common gastrointestinal problems in childhood, yet it is often overlooked.

One reason is that many parents assume constipation means a child is not going to the toilet regularly. In reality, children can be constipated even if they pass stools every day.

Because constipation can present in different ways, the symptoms are not always immediately recognised as being related to the bowel.

What symptoms can constipation cause?

Constipation can affect children in different ways. Common symptoms include:

• abdominal pain
• bloating
• nausea
• poor appetite
• painful bowel motions
• large or hard stools
• stool accidents in underwear.

Some children may also avoid using the toilet because they are worried about discomfort, which can make symptoms worse over time.

How does constipation develop?

Constipation often begins after a painful bowel motion.

To avoid further discomfort, children may start withholding stools. The longer stool remains in the bowel, the larger and harder it can become, making bowel motions even more uncomfortable. This can create a cycle that becomes increasingly difficult to break without treatment.

The good news: constipation is usually treatable

Most children with constipation improve with appropriate management.

Treatment may involve:

• a bowel cleanout if significant constipation is present
• stool softening medications
• dietary strategies
• establishing healthy toileting habits and routines.

The right approach will depend on the child’s age, symptoms and severity of constipation.

When should parents seek medical advice?

Medical review is recommended if constipation is:

• persistent
• associated with poor growth
• causing significant pain
• accompanied by recurrent rectal bleeding
• leading to frequent stool accidents.

Early treatment is important. In general, the longer constipation has been present, the longer it may take for the bowel to recover and return to normal function.

Getting children back on track

Constipation can have a significant impact on a child’s comfort, appetite, confidence and day-to-day activities. The good news is that, with the right treatment plan, most children improve significantly.

If your child is experiencing ongoing constipation or symptoms that may be related to constipation, a paediatric gastroenterologist can help identify the cause and develop a management plan tailored to their needs.