What causes childhood constipation — and does it ever go away? Here’s what parents need to know.
Parenthood comes with its own unique challenges, but having a child who can't poop is up there. If you've ever struggled with the experience of having a child who is constipated, know this: You're not alone. About 1 in every 20 visits children make to the doctor is because of constipation, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
While many people associate constipation with trouble with pooping, it's a little more nuanced than that. When a child is constipated, it means that the child has fewer than two bowel movements (BMs) a week; has stools that are hard and dry, or are lumps; has stools that are difficult or painful to pass; and doesn't feel that as if everything is gotten out when the child goes to the bathroom, according to the NIDDK.
Every child's bowel habits are different, but it is obvious when a child is constipated. "They're usually pretty uncomfortable," Dr. Daniel Ganjian, a pediatrician at Providence Saint John’s Health Center in Santa Monica, Calif., tells Yahoo Life.
But what causes childhood constipation and, more importantly, how can you fix it? Doctors break it down.
What causes childhood constipation?
Childhood constipation is usually broken into two categories, according to the American Academy of Pediatrics (AAP):
Organic constipation: This is constipation that happens as the result of a disease, such as celiac disease, thyroid problems or other disorders.
Functional constipation: This typically happens when kids hold back bowel movements or after they have a gastrointestinal infection.
Many children with constipation have functional constipation, according to the AAP. That can happen for a few reasons, including a fear of pain or discomfort from pooping, a lack of awareness of needing to poop, a way of taking control, not wanting to stop playing to go to the bathroom and being nervous about using public toilets.
But constipation can be complicated. "It's multi-factorial — there are usually several things going on," Dr. Corey Baker, a pediatric gastroenterologist at Connecticut Children's hospital, tells Yahoo Life. That can include a child's diet, Dr. Katie Lockwood, a pediatrician at Children’s Hospital of Philadelphia, tells Yahoo Life. "Most of my patients are constipated due to low dietary fiber," she says. "Even kids who eat a balanced diet are often not eating enough fiber or drinking enough water."
Why is it important to treat childhood constipation?
Constipation is unlikely to just go away without treatment, Baker says, so your child can continue to be uncomfortable if the child does not get relief. Kids who are struggling can also end up having accidents, and that can lead to social issues, Baker says. "Chronic constipation can also lead to a lot of stress and anxiety around bowel movements," he says.
If constipation isn't treated, it can lead to stomach pain, a decrease in appetite, and even vomiting due to a buildup of stool, Ganjian says. "In severe cases, a child may actually develop what appears to be diarrhea — large amounts of loose stool that is leaking around the impacted, harder stool," Dr. Michael Bauer, a pediatrician and medical director at Northwestern Medicine Lake Forest Hospital, tells Yahoo Life.
If your child has constipation that goes on for too long, they can even end up with fecal impaction, which is a large lump of dry, hard poop that stays stuck in the rectum, Ganjian says.
How is childhood constipation usually treated?
If your child is struggling with regular constipation, Bauer recommends talking to your pediatrician "as understanding the basis for the constipation is key to any treatment plan." He says your doctor will likely recommend doing the following:
Making healthy food choices, with at least five servings of fruits and vegetables a day
Making sure your child drinks plenty of water
Take time out during the day for toilet time
Consider using a potty stool to support your child's legs when the child is on the toilet
On the dietary front, Lockwood suggests focusing on foods that start with the letter "P": pears, prunes and peas, which are high in fiber. "In general, fruits and veggies that you eat the skin of are going to be higher in fiber," she adds.
If that still doesn't work, Ganjian recommends using MiraLAX, a gentle laxative that dissolves in liquid that your child drinks. "It's not absorbed by the body — it stays in the GI tract," he says. Bauer also recommends laxatives as needed. "Laxatives can be very helpful and are generally not habit-forming," he says.
Will kids outgrow childhood constipation?
It may feel like you're fighting for every bowel movement now, but experts say that's unlikely to always be the case. While some children with underlying diseases or anatomical differences may have constipation for life, "typically, most kids will outgrow it," Baker says.
If your child is struggling with childhood constipation, Ganjian says it's important to talk to the child's doctor. The doctor can offer personalized advice and guide you as you work to resolve the problem.
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