What is constipation?

A very common condition in children

where they have infrequent bowel movement or difficulty passing stools.

 

Causes of constipation in children

• Not taking enough time to sit and try to pass stool on a routine basis

• Painful experiences around stool passage

• Withholding of stool as a result of past discomfort, fear of pain or not wanting to use the public toilet

• Family history of slower bowel function

• Diets that are too low in fibre

• Not drinking enough fluids

• Medications that are constipating

• Having low muscle tone, neuromuscular problems, and/or developmental delay

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Management of childhood constipation

• Position: use footstool, lean forward and put elbows on knees

• Toilet sits: up to 5 minutes, 4-5 times a day, preferably after meals

• Encourage a routine to sit on toilet. Ensure toileting remains a positive experience

• Chart or diary to reinforce positive behaviour and record frequency of bowel actions

• Physical activity: encourage children to exercise more to help stimulate the bowel

• Review toilet access/investigate barriers to using school toilets

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Dietary modification

Increasing dietary fibre is often not sufficient for treatment of childhood constipation.

Excessive cow milk intake may exacerbate constipation in some children. 

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LAXATIVES

Osmotic and lubricant laxatives are usually required long term (months to years).