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Constipation Is one of the most common conditions seen in the Pediatric GI clinic.

Constipation is defined as:

  • Decreased frequency of bowel movements (if you do not have a bowel movement for more than 2 days)

  • The stool is harder and very large, making it difficult or painful to pass

  • Incomplete evacuation of bowel movement (BM) – Cannot pass all of the stool and feels full.

Diagnosing Constipation

Using the Bristol stool chart will help you tell your doctor the kind of BMs your child is having. It is important for your doctor to know this so he or she can properly diagnose and treat your child.

A normal stool should be types 4 and 5. Type 6 may be normal for infants. Types 1-3 may suggest constipation and types 6 and 7 may suggest diarrhea.

It is also important to tell the doctor:

  • About any prescription and over-the-counter medications and vitamins and supplements, your child takes

  • If your child’s abdomen (lower stomach) is swollen and/or hard (abdominal distension)

  • If your child has lost weight or is not eating very much if at all

  • If your child has a lot of rectal bleeding. It is not unusual to have an occasional small amount of rectal bleeding due to anal fissure.

Treating Constipation

Treating constipation is not an exact science. There are several treatment options to meet the unique needs of each child. Commonly used medications are available over the counter. Treatment typically includes

  1. Diet changes to include more fiber and water

  2. Changing bowel habits – regularly scheduled toilet times and avoid withholding

  3. Medication: There are 2 medication options – stool softeners and stimulant laxatives. One or both may be necessary based on the severity of constipation. Medication treatment has two phases – a three-day, aggressive, cleanout phase and then followed by a maintenance phase. Depending on your child’s age, we will individualize a plan for your child


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