What happens when your child is constipated?

If your child is constipated, watch the video or read on to learn from Erik D. Andrewski, MD, pediatric gastroenterologist at Riley Children’s Health, who offers his expert advice on recognizing and treating constipation in kids.

Causes of constipation

Constipation means hard poop that may happen a few times a week or less. When constipated for a long time, it can lead to encopresis, a condition where stool builds up in the colon and rectum, causing it to stretch and lose control of bowel movements. Pooping may also be painful or straining.

“In kids, constipation may also be from holding their stools in due to prior experiences of fear or pain and is especially common during potty training or when just starting school,” Dr. Andrewski said.

What to expect at a pediatric visit

When you notice constipation in your child, consult your primary care provider, where they will ask you questions about your child’s poop, such as:

• How often they go?
• What does it look like?
• Is it painful?
• Is there blood?
• Do they have poop accidents?
• Are they unable to control when they poop?

Your doctor will also evaluate symptoms like belly pain, vomiting, weight loss and diet, and they will want to know when the difficulty of popping started and if it is getting worse or staying the same. This assessment will help determine the severity of the condition.

Symptoms of constipation

During your pediatric visit, your doctor will check for “red flag” symptoms, which may include:

• Significant weight loss
• Not pooping within the first 24-48 hours after birth
• Muscle weakness
• A change in the way your child walks
• Lead exposure

Your provider may also examine your child’s reflexes and skin changes on the lower back. If they notice anything abnormal, a treatment plan may be recommended.

Treatment options

Depending on the severity of your child’s constipation, your provider might recommend:

• Blood or imaging tests
• Medicine to help the colon contract or keep the stool soft

Additionally, the following are easy at-home treatment options to help with constipation:

• Establish a toilet routine–have your child sit on the toilet for 5-10 minutes after a meal twice a day
• Use a foot stool when pooping
• Minimize distractions like phone or tablet time when pooping
• Blowing bubbles into a pinwheel to help the bottom relax

When to seek emergency care

In some cases, constipation may require emergency treatment, such as when your child develops anal fissure, or a crock or split in the tissues that line your anal canal, causing acute pain and bleeding. Other emergency cases might be required when your child experiences severe abdominal pain or inability to drink enough fluids to stay hydrated.

When to see a specialist

If larger concerns arise, your pediatrician may refer your child to a pediatric gastroenterologist. Referrals are typically made when:

• Constipation is linked to weight loss
• There is concern about an anatomic or structural cause of constipation
• Constipation is so severe it requires admission to the hospital

Expert care at Riley Children’s

Remember, when your child is constipated, your pediatrician can help guide you in the right direction. And as more support is needed, the expert gastroenterology team at Riley Children’s is always here to provide the specialized care and attention your child needs.

Learn more about pediatric gastroenterology at Riley Children’s.