Written By: Dr. Dina Kulik, MD, FRCPC, PEM

Dina is a wife, mother of 4, and adrenaline junky. She loves to share children’s health information from her professional and personal experience. More About Dr Dina.

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What To Do for Painful Constipation in a Child

Your Body

What To Do For Constipation In Kids

Painful bowel movements and constipation is a prevalent issue that many kids experience. Nowadays, constipation in kids is persistent because many children overeat processed food, eat too little fiber, and drink too little water. They are probably following the model of adults who tend to lack a proper diet as well!

To treat constipation in kids, it’s essential to understand what it is. Constipation is abnormalities in both consistency and frequency of bowel movements. Most healthy children tend to stool at least once per day, and the stool is soft and not painful to push out. It should also take just a few minutes. However, when the bowel habits are less frequent than daily, or the bowel movements are hard, painful, bloody, or large volume, this is constipation.

Keep in mind that there is some variation in regular schedules for kids, so if your child follows a healthy lifestyle but tends to skip a day, there may not be cause for concern of constipation and defecation problems. We want to ensure children are comfortable when they have a bowel movement. There should be no pain, straining, or challenges emptying the bowels.


 

What are the symptoms of constipation?

Constipation may not feel like or appear to be a big deal. Many adults and kids are used to sitting on the toilet for long periods and pushing out hard stools or large volume or marble-like stools, but this is not normal. Suppose stooling is painful and takes a while; this likely signals constipation. Your child’s bowel movement should be soft, easy to push out, and at least once a day. There should be no straining. How many bowel movements a week should your child have? They should have at least one bulky stool a day.

Infrequent bowel movements can lead to hard stool, dry stools, abdominal pain, and stool stains in their underwear. Some kids develop an anal fissure that leads to anal bleeding. You will see blood on the toilet paper when you wipe.

Some children will develop anal fissures, which cause bleeding when wiping or blood on the stool or dripping into the toilet.

If you notice any of these symptoms in your child, you may need to make some changes.

 

Causes of constipation in kids

Some causes of constipation include a diet low in fiber or low in fluids. Kids may also become constipated because they tend to withhold their poo when they don’t want to stop playing. The colon absorbs water, so the longer it sits there, the harder and drier it can become. Ignoring this urge makes it more challenging to go later.

Constipation in children can occur at any point. However, it is most common in infants during the transition from formula to solid food, toddlers when they start potty training, and older children when they begin school. Because it’s so common, it’s helpful to know how to prevent it and what to do for child constipation.

Chronic constipation and withholding behavior can lead to weakened pelvic floor muscles and decreased tone in the rectum. This can lead to ongoing issues with hard bowel movements.

Sometimes a child lives a healthy lifestyle but is constipated for precise reasons. For example, they may experience this after taking certain medications, such as pain medications. Some kids develop constipation when they have recent changes in their diet, such as during holidays and vacations. Rarely is constipation due to medical conditions such as thyroid problems or celiac disease. It is best to review your child’s symptoms with your health care provider to ensure we have the correct diagnosis know how best to treat your child’s pain. Your healthcare provider can provide medical advice based on their medical history, your family history, your child’s physical exam, and overall health. Your healthcare provider can review their differential diagnosis and provide medical education about the likely causing constipation in your child. Your healthcare provider can then create a treatment plan tailored to your child and their stool history. Any health conditions can be ruled out appropriately.

Luckily, there are many home remedies for child constipation.

 

What are some constipation treatment strategies?

Sometimes diet and lifestyle changes help a child with painful bowel movements. For example, we can increase fiber and water in their diet.

 

Foods that help constipation

Your child’s diet should be balanced in fruits and vegetables, and grains. A high-fiber diet can help some kids. Ideally, their grains have high fiber, and brown pasta, rice, and bread have more fiber than white carbs.

 

How much fiber does my kid need?

Kids less than three years of age need around 20 g of fiber a day. Older kids need about 25-30 g, and teens need 30-40g/day.

 

Which foods help constipation?

My favorite foods for kids with constipation are legumes, mango, berries, peas, dried fruits, and apples and pear (with the peel on).

Some high fiber foods:

  • One medium baked sweet potato with peel = about 4 g
  • 1 whole-wheat bagel = about 5 g
  • One medium pear or apple with skin = about 6 g
  • One medium orange = about 3 g

Other great foods include garbanzo beans, pinto beans, green beans, lima beans, kidney beans, and green peas. Bran cereal and wheat bran muffins are high in fiber too.

You can find the fiber content of your favorite foods online easily!

 

Make sure they get enough fluid

Most children need a liter or 2 of water per day. Pop and other caffeinated beverages are not suitable substitutes for water because they act as diuretics.

 

Establish a bowel routine

I suggest offering potty time to kids after every meal. Yes, after breakfast, lunch, and dinner. This made going to the bathroom a set and practiced routine instead of a daily battle.

Since I’ve started trying this, my children stool several times after meals with no struggle. Keep in mind that this routine will be much easier to build if your child has regular meal times. Also, a toilet routine can help in the battle against constipation.

Toilet Training

My recommendation is to start putting children on the toilet after meals as soon as they show any interest. For my kids, that was around 18 months.

There were very few successes at that time, but when they did have an “accidental success,” we had a huge party. Then, you reward them with whatever works for them. My older son was rewarded with a single chocolate chip when he had success.

My younger son was rewarded with a sticker. As my kids got older, they had more frequent “accidental successes” and started connecting the dots; when they tried, they were rewarded. When they had success, they were rewarded. So again, the goal is a non-stressful training habit. No pressure.

Constipation medication

While constipation is simple to treat, it can take months for your child to get back on a routine. Once they have been constipated, the bowel starts to stretch out, which can take several months to go back to normal.

Therefore, treating constipation is never a quick fix. In addition to starting more fluid and more fiber, I often use a medication that brings liquid into the poo, called Peg 3350. Some children benefit from a suppository when they are constipation, such as a glycerin suppository or an enema. Ask your doctor about this if you need it.

 

Prevent constipation!

The best way to treat constipation is to prevent it in the first place. First, ensure your child has plenty of fiber and water in their diet. Then, try to get them used to a bowel routine, where they sit for 2-5 min a few times a day, particularly after eating. There is a strong urge to empty after eating, and you can develop a routine this way.

 

When to see a doctor for your kid’s symptoms of constipation

Home remedies for child constipation won’t work 100% of the time.

While constipation does not indicate a severe issue in children, it is essential to see a doctor if constipation comes with more severe pain and symptoms. For example, abdomen swelling, bloody stools or rectal bleeding, fever and vomiting, and unexplained weight loss indicate you should check in with your child’s doctor.

 

FAQ’s – Frequently Asked Questions;

 

How do I get my child to have regular bowel movements?

Give your child more liquids. Drinking enough water and other beverages helps poop move more quickly through the intestines, leading to an easier time passing a bowel movement.

Make sure they’re eating fibre-rich foods like oatmeal or fruit when possible, too–this can help keep their digestive systems healthy, so when it comes time to poo, it passes more quickly.


When do you go to the doctor for chronic constipation?

If you’ve noticed blood in your stool, an unexpected weight loss, or persistent or worsening pain with each bowel movement–it’s time for a visit with your healthcare provider.

 

What is rectal prolapse?

Rectal prolapse is a condition in which part of the rectum protrudes from its standard location. It can be caused by weak muscles that support it, damage done during labor or delivery, and defects within your pelvis region. You may first notice symptoms after prolonged issues with painful or hard bowel movements.

 

What is fecal impaction?

A fecal impaction is a large, hard mass of stool that gets stuck in the colon or rectum.

 

Happy stooling!

Dr Dina Kulik - Kids Health

Written By: Dr. Dina Kulik, MD, FRCPC, PEM

Dina is a wife, mother of 4, and adrenaline junky. She loves to share children’s health information from her professional and personal experience. More About Dr Dina.

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