Constipation after a procedure or injury (3036)

Orthopedics and rehabilitation

What is constipation?

Sometimes, stools (poop) get hard and dry. Your child may be constipated if:

• They have to push really hard to get the poop out.
• the poop is very hard
• the poop is in little balls
• the poop is really large – it may even clog the toilet
• they do not have a bowel movement (BM) for more than 2 to 3 days.

What causes it?

Constipation can by caused by:

• Narcotic pain medicine like morphine, oxycodone, or hydrocodone
• A change in activity levels. This may happen if your child is sick, has a broken bone, is injured or had surgery or has stayed in bed or a wheelchair for a long time.
• Not drinking enough fluid
• A change in the foods that your child eats.

How is it treated?

Have your child drink more fluid and get more fiber in the diet.

• Increase fiber in diet.
    - Fiber is found in fruits, vegetables, and whole grains.
  - To calculate grams of fiber needed:

+ If not constipated = Age (in years) + 5 = total number of grams

+ If constipated = Age (in years) + 10 = total number of grams

• Drink enough water based upon body weight:

Increasing fiber and fluid is often not enough if your child is on bed rest or is taking pain medicines. Other medicine is often needed. Discuss medicines with your health care provider.

Medicine might be taken by mouth or feeding tube:

• Some medicines help keep water in the poop

  - Lactulose for kids less than 2 years
- Miralax for kids over 2 years

• Senna helps the intestine (gut) muscles contract (squeeze) to help move the poop through your body. Senna comes in different forms:

  -  Sennosides liquid
- Senna tablets 
- Ex-Lax chocolate chew bar

• Medicines by mouth can take 1 to 2 days to help with poop. If it has already been 2 to 3 days since your child has pooped, they might need a suppository. A suppository is a medicine given in the rectum (bottom). There are different types of suppositories:
  
   
• Glycerin suppository
  - Good for 2-5 year olds
  - PediaLax Liquid Glycerin is one brand
• Bisacodyl suppository
  
  - 4 to 10 year olds: use 5mg suppository
  - Over 10 years: use 10mg suppository

• Docusate enema

- 2 to 12 years olds: once daily if needed

  - Over 12 years: twice daily if needed

  - Enemeez and DocuSol are brands

• Saline Enema 

- 2 to 4 year olds: give half of a 2.25 ounce dose
- 5 to 11 year olds: give 2.25 ounce dose
- Over 12 years: give 4.5 ounce dose
- Fleets is one brand

• The suppository works faster and better after a meal. 

- Giving it after dinner or breakfast works best. 
- Follow the directions on the medicine package for the right amount.

• If your child has no BM after the first suppository, give another one the next day.
• If your child has no BM after the second suppository, give a Fleets Enema®. Follow the directions on the box. 
• All of the above medicines and treatments are sold over the counter at most drug stores.
• Call the doctor or nurse if your child still does not have a BM after trying all of the above. 
• These medicines and treatments should be used for a short period of time. If your child is still constipated after 2 to 3 weeks, call your child’s health care provider. You can review the medicines and treatments you’ve used so far.

Other helpful teaching sheets:

#1471: Increasing Fiber in your Child’s Diet  
#1101: Giving a Rectal Suppository  
#1348: Enema: Ready-to-Use  
#1844: Constipation 

For more health and wellness information, check out this resource:

https://kidshealth.org/ChildrensWi/en/parents


This sheet was created to help you care for your child or family member. It does not take the place of medical care. Talk with your healthcare provider for diagnosis, treatment and follow-up.