HealthInfo Canterbury

Overview of constipation in children

Mō te kōroke ki ngā tamariki

 

Constipation is a very common problem for tamariki (children). For most tamariki children , constipation means passing hard stools (poo) with difficulty and less frequently than normal.

Soiling (also known as faecal soiling or encopresis) is also a common problem that affects many tamariki. Soiling is when a tamaiti (child) poos in their pants after the age you would expect them to be toilet trained. It can happen to any toddler, or tamaiti child teenager.

Symptoms of constipation in children

Your tamaiti may be constipated if:

• their poo is hard and pebble-like
• they haven't had a poo for four days or more
• they complain of pain or cry when having a poo
• there is bright blood around the poo, this can be caused by tears in the skin around the back passage (anal fissures)
• they complain of tummy pain, which is often relieved by having a poo
• they have soiling accidents.

Causes of constipation in children

There are many reasons why your tamaiti might be constipated.

• Not eating enough fibre. Fibre-rich foods such as wholegrain breads and cereals, fruit and vegetables will help to keep their bowels working regularly. See Fibre & fluids for children for more information.
• Not drinking enough fluids.
• Less activity than normal and not eating and drinking as much, for example when your tamaiti is unwell.
• Holding on. Constipation often starts after one hard poo has caused pain. The natural response to a painful experience is to try to avoid it in the future. Therefore, the next time your tamaiti feels the urge to poo, they hold on to try to avoid passing another painful poo. This results in the poo becoming firmer, larger and even more painful when it's eventually passed, and your tamaiti becomes even more reluctant to poo in the future.

Diagnosing constipation in children

Tests aren't normally needed to diagnose constipation.

Your doctor is likely to ask you questions about your child's bowel habits and diet, and examine your child. The doctor may look at your child's anus to check there are no small splits or tears that may cause bleeding and make it painful for your tamaiti to pass a poo.

Your doctor may also check that there's no underlying disease or condition that might be causing your child's constipation.

Treating constipation in children

You can help your tamaiti child by increasing the fluid and fibre in their diet, encouraging daily physical activity and having a regular toilet habit. Helping your child with constipation has more information about this.

Sometimes tamariki children will also need medication to help with constipation known as laxatives.

  HealthInfo recommends the following videos

• Pediatric Gastroenterology Clinic at Primary Children’s Hospital – Constipation in Children

  This video will teach you why constipation happens to tamariki and what you can do to fix it.

  HealthInfo recommends the following pages

• KidsHealth.org.nz
  • Constipation in children

    Information about the signs and symptoms of constipation and what you can do about it.

  • Soiling (encopresis)

    Information about what causes soiling in tamariki and what you can do to help.

• NZ Continence association – Faecal incontinence (soiling)

  Information about soiling in tamariki including treatment and advice about diet and fluids.

• The Royal Children's Hospital Melbourne – Constipation in children

  Information about the causes and treatment of constipation in tamariki.

  The factsheet is also available in Arabic, Assyrian, Burmese, Chinese (simplified), Chinese (traditional), Karen, Persian, Somali, Turkish and Vietnamese.

On the next page: Helping your child with constipation

Written by HealthInfo clinical advisers. Last reviewed February 2022.

Page reference: 394427

Review key: HICOC-14683