Constipation refers to when an infant or child has difficulty passing stool (bowel movements). This can mean that the stools are infrequent, hard, large, or takes a lot of effort to pass. Sometimes, chronic constipation can lead to encopresis (fecal soiling from an over-stretched rectum).


Stools are either too firm/hard or large/wide to pass easily, or they are not going frequently enough, or getting enough out each time. Some children do not know that they are constipated, but then start to leak soft/liquid stools. This is a sign that they have been constipated for a long time. It is important for parents and children to know what the stools are like when coming to see us.


Causes can vary. Most children have constipation from not eating enough fiber or drinking enough water. Others wait too long before going to the bathroom, which can lead to stools becoming harder and harder to pass. Sometimes side-effects of certain medications can also lead to constipation. For a few infants and children, there may be more serious (yet rare) causes of constipation which may require special tests.


Depending on the age of the child, and based upon the answers we get from asking many detailed questions and doing a thorough exam, some infants and children with constipation may not need any further testing. Other children may need additional tests (blood tests and x-rays). 


Treatment depends on the child’s age and the underlying cause. Most children will require stool softeners or laxatives, such as PEG-3350 or lactulose. Children will also be counseled on eating more fiber, drinking more fluids, and making time in their daily schedules to sit on the toilet regularly.