Symptoms of Constipation in Children

Constipation is the decrease in frequency of the passage of stools or the painful passage of hard stools. For children, the frequency of stool elimination can vary from one to the other. Normally, however, a child should have a bowel movement at least once every three days. According to the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, 3 percent of all visits to a pediatrician are due to constipation issues.

Causes

• Children older than 18 months may develop constipation because of deliberate stool withholding. Over time, the child's brain may disregard the repeated urges to have a bowel movement, resulting in constipation. Other causes include unbalanced diets and diets high in sugar, illnesses that cause fever, decreased appetite, dehydration and some antidepressants and over-the-counter cold medicines.

Symptoms and Signs

• Children with constipation typically have large, hard stools or hard pellet-like stools. Infants may extend their legs and press together the anal and buttock muscles to prevent a bowel movement, while toddlers may rise up on their toes, move back and forth and hold their legs and buttocks rigidly. Sometimes, abdominal cramping, decreased appetite, nausea or vomiting, urinary incontinence and reoccurring urinary tract infections can also be symptoms.

Treatment

• Infant and toddler treatment for constipation is different than for adults because bowel movement patterns change from early infancy until 3 or 4 years of age. At-home treatments include: positive reinforcement for having bowel movements, establishing a routine schedule to use the bathroom within 30 minutes after meals, maintaining hydration with fluids and juices, and eating well-balanced meals consisting of whole bran cereals, fruits and vegetables. A doctor may prescribe a laxative depending on the age of the child and severity.

Testing

• Contact a doctor for constipation that isn't resolved through at-home treatments. A physician may perform a general exam to look for signs of diseases that cause constipation. Special attention will be given to the abdomen for distention, tenderness or a hard stool that can be felt, as well as inspection of the anal area to check for hard stool in the rectum, or to see if the rectum is dilated. The doctor may also examine stool for blood and review family history to determine if constipation could be hereditary.

Warning

• Call a doctor immediately if in addition to constipation, a child has severe abdominal pain, nausea, vomiting, decreased appetite, fever or bloody diarrhea. These may be symptoms of constipation, but could also indicate a more serious medical condition. Constipation could produce anal fissures, or cracks in the skin. The fissures could bleed or increase pain, causing a child to continually withhold stool. Children that withhold stool for periods of time lasting more than one or two weeks, could develop fecal impaction, which could result in a doctor performing disimpaction to remove the stool.