Constipation means that bowel movements are hard and dry, difficult or painful to pass, and less frequent than usual. It is a common problem for children, but it is usually temporary and no cause for parents to be concerned.

When a child does not eat enough fiber, drink enough liquids, or get enough exercise, constipation is more likely to occur. It also happens when children ignore the urge to have a bowel movement, which they often do out of either embarrassment to use a public bathroom, fear or lack of confidence in the absence of a parent, or unwillingness to take a break from play. Sometimes constipation is caused by medicines or a disease.

Symptoms of constipation include

• no bowel movement for several days or daily bowel movements that are hard and dry
• cramping abdominal pain
• nausea
• vomiting
• weight loss liquid or solid, clay-like stool in the child's underwear--a sign that stool is backed up in the rectum

Constipation can make a bowel movement painful, so the child may try to prevent having one. Clenching buttocks, rocking up and down on toes, and turning red in the face are signs of trying to hold in a bowel movement.

Treatment depends on the child's age and the severity of the problem. Often eating more fiber (fruits, vegetables, whole-grain cereal), drinking more liquids, and getting more exercise will solve the problem. Sometimes a child may need an enema to remove the stool or a laxative to soften it or prevent a future episode. However, laxatives can be dangerous to children and should be given only with a doctor's approval.

Although constipation is usually harmless, it can be a sign or cause of a more serious problem. A child should see a doctor if

• episodes of constipation last longer than 3 weeks.
• the child is unable to participate in normal activities.
• small, painful tears appear in the skin around the anus.
• a small amount of the intestinal lining is pushed out of the anus (hemorrhoids). normal pushing is not enough to expel stool.
• liquid or soft stool leaks out of the anus.

For More Information
American Academy of Pediatrics National Headquarters
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098
Phone: (847) 434-4000
Fax: (847) 434-8000
Internet: www.aap.org

International Foundation for Functional Gastrointestinal Disorders (IFFGD) P.O. Box 17864
Milwaukee, WI 53217
Phone: 1-888-964-2001 or (414) 964-1799
Fax: (414) 964-7176
Email: iffgd@iffgd.org
Internet: www.iffgd.org

Additional Resources
International Foundation for Functional Gastrointestinal Disorders
P.O. Box 17864
Milwaukee, WI 53217
Tel: (414) 964-1799

Intestinal Disease Foundation
1323 Forbes Avenue, Suite 200
Pittsburgh, PA 15219
Tel: (412) 261-5888

Additional Information on Constipation in Children
The National Digestive Diseases Information Clearinghouse collects resource information on digestive diseases for the Combined Health Information Database (CHID). CHID is a database produced by health-related agencies of the Federal Government. The CHID database located on the World Wide Web at http://chid.nih.gov/simple/simple.html, provides titles, abstracts, and availability information for health information and health education resources. See the results of our CHID research on "Constipation in Children," March 22, 2002.

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