Help manage constipation in kids

It’s a topic that doesn’t have to be taboo, as challenges within bowel movements happen to everyone across the globe. As children grow and progress through different stages of life, it’s natural for their diet to change, which can in turn cause bowel movement challenges such as constipation.

As a valued part of the community and someone readily available to a parent or guardian, pharmacy assistants can offer tips and advice to help with their child’s constipation. PAs can also wave the flag as to when they should contact their GP to deal with more severe circumstances.

Here, we cover the signs to look out for when it comes to concerns over children’s bowel movements, and what the best action would be in managing the problem.

Why does constipation occur?

Constipation within children has a number of causes, which include, according to the Mayo Clinic:¹

Withholding bowel movement. A child who may be afraid to use the toilet, or doesn’t want to take a break from play, might withhold a bowel movement, causing greater challenges later.

Toilet training issues. A child who begins toilet training too soon could rebel and hold onto the stool.

Changes in diet. Lack of fibre-rich fruit and vegetables can cause constipation and is one of the more common reasons for a child to experience challenges with bowel movements.

Changes in routine. Changes such as travel, stress or the onset of hot weather can cause complications. Children are also most likely to experience constipation when they first start school outside of the household.

Medications. Certain antidepressants and other medications can contribute to constipation.

Family history. Children with family members who have experienced constipation are more likely to experience it themselves.

Consequences

The Royal Children’s Hospital Melbourne (RCHM) advises that children can suffer a range of long-term consequences due to unmanaged constipation. One is the child soiling themselves, which happens after a child’s rectum has been full of faeces for too long and becomes stretched. A child may not get the urge to go to the toilet because of this state of feeling stretched and will pass faeces without feeling it.²

Signs of constipation among children 

The RCHM points to the following symptoms:²

• Stomach cramps (the pain in the stomach is often intermittent).
• The child feels less hungry than usual.
• Irritable behaviour, short temper.
• Anal fissures: small splits of skin around the anus that can cause pain and bleeding when passing faeces – caused by straining to pass.
• Holding-on behaviour, such as squatting, sitting crossed legged or refusing to sit on the toilet.

Tips for managing constipation

According to the Mayo Clinic, parents or guardians can help manage constipation in children by:¹

• Offering the child high-fibre foods. The recommended intake for dietary fibre is 14g per 1000 calories in a child’s diet.
• Encouraging them to drink plenty of fluids.
• Encouraging physical activity.
• Creating a toilet routine.
• Reminding them to listen to their body, and go to the toilet when necessary.
• Being supportive, as this can be a sensitive time for the child, both physically and mentally.
• Reviewing medications – checking if these may be causing constipation, and adjusting accordingly.

A parent or guardian should be advised to see a GP if constipation is accompanied by the following symptoms:¹

• Fever.
• Not eating.
• Blood in the stool.
• Abdominal swelling.
• Weight loss.
• Pain during bowel movements.
• Part of the intestine projecting from the anus (rectal prolapse).

References:

1. Mayo Clinic, 2023. ‘Constipation in children’.
2. The Royal Children’s Hospital Melbourne, 2023. ‘Constipation’.

This feature was originally published in the July issue of RPA e-magazine.