When do you call your child is constipated?

When your child has less than 3 bowel movements per week, stool is hard, dry and sometimes pellet like or large bulky stool difficult to flush, along with foul smelling wind, unhappy, angry, irritable mood.

Constipation affects 30% of children, usually temporary but in 1/3 children it becomes chronic and long standing.

When does constipation commonly occur in children?

When a child’s diet moves from breast milk or formula to solid food (weaning), during toilet training (starting too early or too much parental pressure), when school starts with an unfamiliar setting and concerns of timing, while travelling, when a child starts withholding during playing or fear of toilets.

Common symptoms in children

  • Painful bowel movements, crying
  • Behavioral changes (stool withholding behavior) like crossing legs, standing on tip toes, clenching legs and buttocks
  • Physical discomfort – belly pain, cramps, bloating, reduced appetite, nausea
  • Soiling underclothes
  • Streaks of blood on stool

What are the complications of chronic constipation

  • Painful break of skin – anal fissure
  • Leaking out of stool → social, psychological and educational consequences
  • Prolapse of rectum (last part of colon)

When to seek medical advice

  • Symptoms longer than 3 weeks
  • Severe stomach pain, blood in stool, vomiting
  • Low appetite, losing weight
  • Persistent soiling or behavioral issues

How to manage and prevent constipation

  • Establish a routine toilet time, 10–15 minutes after meals
  • Dietary modifications – encourage adequate water consumption, fiber rich food like fruits and vegetables
  • Regular play and exercise to stimulate bowel
  • Comfort measures – postpone toilet training for a few weeks, use foot stool to help posture
  • Remind your child to pay attention to nature’s call
  • Be supportive – reward your child’s effort for trying to defecate, don’t punish the child for soiling underclothes

  • Use doctor recommended laxatives

Early identification and effective treatment can improve the outcome of constipation.

– Dr. Nasrin Sirajudeen

Specialist Pediatrics at SMC

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