Constipation in children is a common problem which needs support from parents and as well as paediatrician’s advice.

What is constipation?

Infrequent bowel movement with passage of hard stools is known as constipation.

What are the common causes of constipation in a child?

Many factors contribute to constipation in children such as

• Changes in diet– not enough fibre, fruits and vegetables in diet
• Improper toilet training– if you began toilet training too soon, your child may start holding the stool. Usually toilet training starts from 18months to 24months of age.
• Stress and hot weather
• Withholding of stool when they are uncomfortable using public toilets
• Cow’s milk allergy- Allergy to cow’s milk or consumption of too much dairy products.
• Some medical conditions like anatomic malformations, hypothyroidism, neurodevelopment impairment and digestive system problems. 

What are the symptoms and signs of constipation?

• Less than 3 bowel movements per week
• Passing hard and dry stool 
• Straining and pain while passing stool
• Decreased appetite and intermittent stomach pain
• Soiling of your child’s underwear
• Sometimes blood stains along with hard stool may be seen
• Child crossing his or her legs, clenching buttocks while attempting to pass stool

What are the risk factors for childhood constipation?

• Sedentary life style and less outdoor activity
• Poor dietary habits with not enough fibre
• Not drinking adequate amount of water
• Child having neurological disorders

What complications can occur due to chronic constipation?

Usually constipation will not cause serious complications. However, if it becomes a chronic problem then the following complications can occur:

• Recurrent urinary tract infections
• Painful breaks in the skin around the anus (known as anal fissures)
• Part of rectum comes out of anus (Rectal Prolapse)
• Withholding of stool due to pain can lead to leakage of stool and soiling of underwear (Encopresis)

How to prevent constipation in children?

• Promote physical activity
• Encourage your child to drink more fluids and to take adequate fibre in diet.
• Maintain a daily toilet routine
• Be supportive and reward for good bowel habits
• Don’t skip medications for any medical condition that can lead to constipation (Eg:Hypothyroidism)

Which foods are rich in fibre?

• Green leafy vegetables – Spinach, Lettuce, Cabbage, Broccoli etc
• Fresh Fruits – Green banana, Papaya, Apple, Orange, Grapes, Kiwi, Pears, Strawberries  & Guava etc
• Wheat, Oats, Chickpeas, Corn, kidney beans and nuts like almonds etc.

What foods need to be avoided in diet?

• Cookies, Chocolates, Chips, Cakes, Soft drinks, Excessive dairy products, fried foods, Red meat, too much refined sugar etc.

When do you need to see your Paediatrician?

Take your child to paediatrician when 

• Constipation lasts longer than 2weeks
• Burning sensation/ crying while passing urine
• Crying or refuses to squat due to pain around the anus.
• If its associated with decreased appetite
• Presence of blood in stool
• Abdomen distension 
• Part of large intestine comes out of anal opening (rectal Prolapse)

Bristol stool chart helps you in identification of type of stool your child is passing