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Constipation in children
Category: Babies & Children · All children symptoms
What it can feel like
Constipation in children means hard, infrequent stools that are painful to pass — often with large-sized stools, straining, withholding behaviour (crossing legs, hiding), tummy aches, overflow soiling, and reduced appetite. It is common, miserable, and self-perpetuating: one painful stool teaches withholding, which makes the next stool harder.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Constipation in children can be associated with withholding after a painful stool or anal fissure, low fluid and fibre intake, toilet-training transitions, school toilet avoidance, and changes in routine — the functional constipation cycle accounts for the great majority.
Other possible causes
Constipation present from birth with delayed passage of the first stool, a persistently swollen abdomen and poor growth can be associated with Hirschsprung disease (missing nerve cells in the bowel wall); constipation with weight gain and tiredness with an underactive thyroid; and spinal problems when bladder function and leg neurology are also affected.
Red flags — when to seek help promptly
- Constipation in a newborn who did not pass meconium in the first 48 hours
- Constipation with vomiting, a very swollen abdomen or severe pain
- Constipation with poor growth, weight loss or blood in the stool (beyond a small streak from a fissure)
- Constipation with weakness, abnormal leg reflexes or bladder problems
- Overflow soiling that is new in a school-age child, or constipation not responding to proper treatment
What a clinician may do
A clinician will take the stool and behaviour history, feel the abdomen, and examine around the anus; blood tests and imaging are reserved for red-flag patterns. Treatment follows a ladder: disimpaction with osmotic laxatives first when loaded, then maintenance laxatives for months (not days), toilet routines, and rewards for sitting — retraining the bowel takes time.
Related guides on MedicalVideos.com
Frequently asked questions
Why do laxatives continue for months if the stool is soft now?
A chronically loaded rectum is stretched and loses its urge sensation; it takes months of staying empty for it to shrink back and feel properly again. Stopping early when stools soften is the commonest cause of relapse — maintenance is measured in months, tapered slowly.
Is my child withholding on purpose to be difficult?
No — withholding is a learned protective reflex: a hard stool hurt, so the child clamps down when the urge comes, and the stool dries further. It looks defiant and feels frustrating, but it is pain-avoidance, managed with softening and patience rather than pressure.
Related symptoms — Babies & Children
Browse the C section of the A–Z list or return to the Symptoms A–Z hub.