Kids and constipation: How to keep things moving

People avoid talking about constipation, but it’s a common problem in kids, especially those ages 2-4 who are potty training. Constipation can happen in summertime, as kids tend to play outside and get dehydrated, forgetting to drink and replace fluids.

Common causes

Constipation can be caused by too little fiber or liquid in the diet, lack of exercise, and/or emotional issues. Some infants may also get constipated when switching from breast milk to formula.

Sometimes kids are too busy playing and forget to go to the bathroom, or ignore signals from their body telling them it’s time. Starting a new school year can also lead to constipation, since kids are put on a new schedule and may need to change their bowel routine.

A vicious cycle

Once a child becomes constipated, hard, dry stools can be painful to pass and he may avoid using the bathroom to avoid discomfort. A child who arches his back or crosses his legs to squeeze his buttocks together may be trying to avoid having a bowel movement. Repeated avoidance of bowel movements can lead to chronic constipation.

How to help your child

If your child experiences constipation, don’t panic — there are several home remedies that can help nip constipation in the bud.

• Balanced diet. A combination of high-fiber foods, along with plenty of fluids can be very effective. Summer is a perfect time to add fresh fruits and veggies to your child’s diet. Having kids help select fresh foods at the grocery store or farmers’ market may even entice them to eat more! Just fiber alone won’t help — drinking water is essential for moving bulk through the intestines. Limit fast foods, junk foods and caffeinated beverages including cola.
• Increased exercise. Exercise aids digestion by helping the intestines push food forward, and summertime is a great opportunity to get outside and be active. Encourage your child to go out and play rather than watching TV.
• Comfortable toileting. Have your child sit on the toilet twice a day for 10 minutes, preferably after a meal. Be sure your child is comfortable — if feet don’t reach the floor, put a stepstool in front of the toilet so your child can rest their feet to bear down effectively and relax the pelvic floor.
• Stool softener. For occasional constipation, an over-the-counter stool softener can be effective.

When to get help

If constipation isn’t resolved at home, it’s time to check in with your child’s primary care physician. Stubborn, chronic constipation may need additional treatment or medication. Some cases of constipation are caused by physical problems, such as abnormalities of the intestinal tract or endocrine problems. These can be detected with a diagnostic test such as an abdominal X-ray or lower GI series. Other cases of constipation may require behavioral interventions if a child is withholding bowels due to pain or stress, being embarrassed to use a public bathroom, or being overwhelmed with toilet training – all common emotional causes of constipation.

At Children’s Wisconsin, experts in our Constipation Program will diagnose the root cause of your child’s constipation and use a combination of education, behavior management and medical interventions to meet their unique needs. Our team includes gastroenterologists, experienced nurse practitioners, dietitians and psychologists who specialize in treating chronic constipation.

Finding the right solution for a child’s constipation helps the child and everyone in the family breathe easier and feel better. The good news is most constipation is a temporary situation, and up to 90 percent of kids will have no long-term problems.

Manu Sood, MD Gastroenterologist Gastroenterology, Liver and Nutrition Program

Children’s Wisconsin has more than 20 primary care offices conveniently located throughout the Milwaukee area and southeast Wisconsin. Find a pediatrician near you.