Pediatric Constipation

Constipation is a common problem for children. This page can help you learn what to do. You’ll find:

  • How to recognize signs of constipation.
  • A guide on when to call your child’s doctor.
  • Tips for keeping your child’s system working.

Understanding pediatric constipation

Constipation — infrequent bowel movements or hard, dry stools that are hard to pass — is usually easy to treat.

Every child’s bowel patterns are different, so it’s hard to say what is normal. But children with one or more of these signs may be constipated:

  • Bowel movements many days apart
  • Hard, painful stools
  • Stomach pain or cramps
  • Small amounts of stool in underwear
  • Bleeding
  • Reluctance to go to the bathroom

  • Stress or emotional issues: New situations and changes in routine can trigger constipation. Your child might be embarrassed about using a public bathroom, for example, when they start school.
  • Diet: Shifting your infant to solid food can cause constipation. For older children, too little fiber, too much high-fructose corn syrup or even sugar-free gum can be the cause.
  • Illness: Loss of appetite during a cold or flu can affect bowel patterns.
  • Toilet training: Your child may not want to use the toilet at first and may hold in stool.
  • Withholding: Your child may not want to go. Examples include fear of a painful bowel movement or not wanting to stop playing.
  • Medications: Constipation can be a side effect of some medications.

When to call a doctor

Contact your child's primary care provider if you have questions or concerns about your child's bowel patterns. Most of the time, your child’s doctor can treat constipation. The Doernbecher Behavorial Pediatrics team can help with toileting issues.

Gastroenterology specialists at OHSU Doernbecher Children’s Hospital can talk to your pediatrician by phone if needed.

The National Institute of Diabetes and Digestive and Kidney Disease recommends calling a doctor right away if your child’s constipation lasts longer than two weeks or if your child has constipation and:

  • Bleeding from the rectum.
  • Blood in their stool.
  • Bloating and/or vomiting.
  • Constant belly pain.
  • Weight loss.

Diagnosing pediatric constipation

Your child’s doctor can do an exam and ask about your child’s symptoms. If your child’s constipation doesn’t go away or keeps coming back, tests might include:

  • Blood, stool and urine tests.
  • Motility tests to see how well your child’s digestive system is working. These might involve using a small balloon to test muscle and nerve function, or having your child swallow a capsule that transmits information.
  • X-rays, ultrasound and CT (computed tomography) scans, if other tests are inconclusive.
  • Endoscopy and colonoscopy. These tests use a thin tube with a camera to check your child’s digestive system.

Treating pediatric constipation

The most common ways to treat constipation in children include:

  • Diet: Giving your child more high-fiber foods and less high-fructose corn syrup is usually a good first step.
  • Behavior changes: Teach your child to not postpone bowel movements when busy, stressed or sick. Setting a bathroom routine can help.
  • Medications: Your child’s doctor may recommend over-the-counter stool softeners, fiber supplements or mineral oil. Never give your child a laxative without talking to a doctor.
  • Enemas: The doctor may recommend an enema if stool has built up. In more serious cases, this may be done at the hospital. Don’t give your child an enema at home without talking to a doctor.

What you can do at home

  • Have your child eat high-fiber foods.
  • Set up a bathroom routine. This can be once or twice a day for 10 minutes, usually after a meal. Reward your child’s efforts, whether they work or not.
  • Make sure your child is physically active.
  • Track your child’s bowel movements in a diary. Watch for changes when your child’s routine changes, such as the start of school.
  • If your child gets constipated during toilet training, stop for a while. Waiting a few months may be better than forcing the issue.

Resources on constipation

For families

Call 503-346-0640 to:

  • Request an appointment
  • Seek a second opinion
  • Ask a question


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