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Constipation in Children (cont.)

Drugs and Other Causes of Constipation in Babies and Children

Many other things can contribute your baby or child getting constipated.

  • The most common cause in a child older than 18 months is a willful avoidance of the toilet (for various reasons). For example, toddlers are often so involved in their play that they lack time or patience for toilet breaks.
  • At school they may be concerned with lack of privacy or the cleanliness of the bathroom.
  • They may have had a prior painful or frightening experience that makes them want to avoid the bathroom. Over time, their brain learns to ignore repeated urges by the colon to visit the bathroom. As stool remains in the colon, the colon will absorb water out of the stool, making it hard and dry. This hard stool is even more difficult or painful to pass, which causes the child to continue "holding it."
  • Changes in diet, or a different diet affect bowel habits. In adults, high-fiber diets have been shown to improve bowel function. In children, however, high-fiber diets have not been proven to improve constipation. Infants and children who eat well-balanced meals typically are not constipated.
  • Breastfed infants will generally have more stools per day. Their stools vary more in frequency when compared to bottle-fed infants. For example, breastfed infants produce anywhere from 5-40 bowel movements per week; whereas formula-fed infants have 5-28 bowel movements per week. Switching the type of milk (or formula) can also cause constipation.
  • Teenagers and toddlers who eat a lot of sugar and desserts are prone to difficult passing of their stools.
  • Any intense changes in a child-such as illnesses causing fever, becoming bedridden, eating less, or dehydration may decrease the frequency of stools or may harden stools.
  • Some medications can make children more likely to be constipated. Common contributors include over-the-counter cold medications and antacids. Antidepressants, anticonvulsants, chemotherapy medications, or narcotic pain medications (such as codeine) can also constipation.
  • Other possible causes of constipation are depression, coercive toilet training, attention deficit disorders, and sexual abuse.

When Should I Call My Pediatrician or Other Health Care Professional?

If none of the home care measures is working, call the doctor. He or she may prescribe a laxative. The type of laxative depends on the age of the child and the exact problem. You may need to make an appointment with a doctor.

If the child has significant abdominal pain, nausea, vomiting, decreased appetite, fever, or bloody diarrhea, he or she needs to see a doctor immediately. Many of these symptoms can be related to constipation. Some symptoms can indicate a serious medical condition.

How Can Doctors or Other Health Care Professionasl Find the Cause (Exams, Tests, Diagnosis)?

  • A health care practitioner will perform an examination to assess the child's general appearance and growth. The health care practitioner will look for signs of diseases that may cause constipation.
    • Close attention to the abdominal exam may reveal distention, tenderness, or hard stool that can be felt.
    • Anal inspection will be performed to check for problems. The The health care practitioner may perform a digital rectal exam with his or her finger to check for hard stool in the rectum or to see if the rectum is dilated.
    • The stool may need to be tested for blood.
  • Usually no diagnostic tests or X-rays have to be performed if the history and exam suggest constipation. Sometimes an abdominal radiograph (X-ray) is obtained and shows stool in the colon. If a medical problem is suspected as the cause of constipation, blood tests or other abdominal imaging studies may need to be performed.
  • The most useful tool the doctor can use to diagnose constipation is the history given by the parents. A doctor needs to know the following:
    • What is meant when parents use the term constipation and how long has the condition been present?
    • What is the size and consistency of the stools?
    • How frequent are the bowel movements?
    • Is pain present with stooling and is there blood present?
    • Is abdominal pain a problem?
    • Is there poor appetite, weight loss, or poor weight gain?
    • Are episodes of fecal soiling present?
    • Does the child use the bathroom at school?
    • What over-the-counter, herbal, or prescription medications are being taken?
    • What type of diet is the child on?

After the initial diagnosis, regular scheduled visits to the doctor should be made in order to ensure that the therapy continues to work and to prevent relapses. As soon as a problem develops, call your pediatrician or other health care professional.

Medically Reviewed by a Doctor on 9/11/2017

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Concern about bowel function has been prevalent throughout history acrossmany cultures.

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