Constipation affects up to 30 percent of children and accounting for an estimated 3 to 5 percent of all visits to Paediatricians. The peak prevalence is during the preschool years.

Complaints range from infrequent bowel evacuation, small hard feces, difficult or painful evacuation of large-diameter stools, and fecal incontinence (voluntary or involuntary evacuation of feces into the underwear, also known as encopresis).

Functional constipation is responsible for more than 95 percent of cases of constipation in healthy children one year and older and is particularly common among preschool-aged children. It is important to evaluate affected children to identify the few that have medical causes of constipation, most important being Hirschsprung’s disease and cystic fibrosis. Children with functional constipation benefit from prompt and thorough treatment interventions. Delayed or inadequate intervention may result in stool withholding behavior with worsening constipation and psychosocial consequences. In an infant, apparent straining during defecation does not necessarily indicate constipation. If accompanied by the passage of soft stools in an otherwise healthy infant, this is normal. Dietary factors that sometimes contribute to constipation include low fiber content (few fruits or vegetables) and low fluid intake.

In most cases, medical causes of constipation can be excluded by a careful history and physical examination. Occasionally blood tests and medical imaging is performed.

If you are worried about your child, make an appointment for an assessment.