Constipation in children
Constipation in children is a common problem, and is not very easy for parents to deal with. The good news is that it usually clears up with time. Parents often worry that it means there is something seriously wrong, but this is very seldom the case. Constipation does seem to make bedwetting more likely, and one study found that improving constipation cured or significantly improved bedwetting in 6 out of 10 children (New England Journal of Medicine 2009;360:1429–36).
What is normal?
Normal healthy children vary in how often they have their bowels open. Most children aged 1–4 years pass faeces once or twice a day. However, some children have their bowels open three times a day, whereas others have a bowel motion every other day. All this is quite normal. And a few perfectly healthy children have their bowels open once every 3 days.
The size and consistency of the faeces will vary, depending on what your child has been eating and drinking.
How do I know my child is constipated?
Signs of constipation are:
- your child seems to be straining hard to have a bowel movement
- having a bowel movement is painful – suspect this if your child seems to be trying to hold the bowel motion in (e.g. by crossing the legs or sitting up on the heels) or if your child seems frightened of using the toilet
- the stools are very hard and dry.
Causes of constipation in children
How to help your child
Check your child’s position on the toilet. Provide a child’s toilet seat (which fits over the normal seat), because it will make your child’s hip bend at the optimum angle for having a bowel movement. The best posture for passing faeces is for the child to sit in the middle of the toilet with the legs apart and the heels flat on a footstool (New England Journal of Medicine 2009;360:1429–36). He or she should be told not to rush or push.
When to see your doctor
What your doctor can do
Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Tuesday, April 5th 2011
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An average person on a typical Western diet passes about 150 g (5 oz) of faeces each day. Faeces consist of about one-third solids and two-thirds water
The solid matter in faeces is cellulose from vegetables, dead cells cast off from the lining of the gut, bacteria, some salts and pigment from bile (which gives the brown colour)
Most of the waste matter from food is passed out in the faeces within 72 hours, but in healthy people up to 30% may remain in the colon for a week or more
Defecation is a very efficient process, normally taking only 10 seconds. Presumably it has to be quick - animals (and primitive man) cannot run from a predator easily if they are in the middle of defecating. This is probably why it is even quicker when we are frightened
In the USA, more than $800 million is spent on laxatives each year
Constipation results in more than 2–5 million visits to doctors in the USA each year
About 4,500,000 people in the USA say they are constipated most or all of the time (National Health Interview Survey)
In a UK survey, 6% of people said they had suffered from constipation in the past year, 13% had some difficulty in passing their faeces at least once a month, and 19% took laxatives at some time