When bowel movements are infrequent and associated with symptoms, it is called constipation. Food product waste (stool) may become hard and dry while in the intestines, making it painful to pass and causing strain. Constipation may be intense and develop suddenly (acute) or develop gradually and last for long periods of time (chronic).

Constipation is fairly common in children and accounts for about 3 percent of child visits to general pediatric clinics, according to the American Academy of Pediatrics (AAP). It can occur when a child fails to eat enough high-fiber foods, drinks too few liquids or is too inactive. In addition, children may develop constipation when they undergo dietary changes (such as switching from breast milk to solid foods), during toilet training or from ignoring the body’s signals to pass a bowel movement. In many cases, a cause for a child’s constipation cannot be determined.

Most children experience constipation that corrects itself with time, changes in diet or increased physical activity. In most cases, it is temporary and not serious. In rare cases, long-lasting or severe constipation in a child may indicate a more serious underlying disorder, such as celiac disease (an inherited, autoimmune disease in which the lining of the small intestine is damaged from eating gluten and other proteins found in wheat, barley, rye and possibly oats), Hirschsprung’s disease (a congenital condition in which the large intestine becomes obstructed due to inadequate muscular movement of the bowel) or hypothyroidism (low production of thyroid hormone by the thyroid gland).

Many people mistakenly believe that it is necessary for a child to have a bowel movement every day. However, the frequency of bowel movements is dependent on age and can vary greatly from child to child. Some children may have as many as three bowel movements a day, whereas others may have just a single bowel movement every three days. The number of bowel movements decreases during infancy and childhood.

Other symptoms may appear with constipation, including abdominal pain, cramping and nausea. Children may develop complications as a result of constipation, including anal fissures (small cracks or tears in or around the anus) and fecal impaction (buildup of stool in the colon or rectum). Some of these can also cause or contribute to constipation.  

In most cases, constipation is a temporary problem that requires no medical treatment. Adding fiber to a child’s diet and increasing fluid intake and exercise may be all that is needed to relieve constipation that occurs without fecal impaction (and no underlying medical condition). However, in some cases a physician will need to administer suppositories, perform an enema or prescribe laxatives in order to relieve a child’s constipation.