Constipation in children – symptoms, causes and treatment
Hard or painful stools are one of the most common stomach symptoms in children. Here you will find answers to what constipation is, why it occurs, and how it can be treated.
Constipation in children is a condition in which stools become hard, infrequent or painful to pass. The condition is very common during childhood — approximately 20% of children aged 4–18 have experienced constipation at some point, while around 3% of children aged 0–2 are affected. In the vast majority of cases — approximately 95% — there is no underlying disease, and the condition is referred to as functional constipation.
What Are the Symptoms of Constipation in Children?
Most symptoms are related to stools being hard, lumpy or passed too infrequently. Children may experience abdominal pain, reduced appetite and general discomfort, particularly before going to the toilet.
There is considerable normal variation in how often children have bowel movements. Most children over the age of one have a bowel movement once or twice a day, but some only pass stools every second or third day without this being a problem, provided the stools are soft and easy to pass. In infants, bowel movement patterns vary even more — breastfed babies may have anything from several bowel movements a day to just one per week, and this can be completely normal.
One sign that many parents overlook is accidental soiling or loose stools that suddenly leak out. This can actually indicate that the rectum is filled with hard stool and that liquid stool is passing around the accumulated mass.
In older children, it is common to see them deliberately tense their pelvic muscles and buttocks to hold back stools, usually because they have previously experienced pain when using the toilet.
What Causes Constipation in Children?
The most common cause is that the child has experienced a hard or painful bowel movement and subsequently begins, often unconsciously, to hold back stools to avoid the pain happening again. This makes the stool even harder the next time, creating a vicious cycle.
Other contributing factors may include insufficient dietary fibre, inadequate fluid intake, dietary changes (such as switching from breast milk to formula or introducing solid foods), fever or other illnesses. In older children, poor or inconsistent toilet habits may also contribute, for example when starting school or nursery.
In rare cases — approximately 5% — constipation may have an underlying organic cause, such as a congenital abnormality of the intestine. These cases typically appear very early in life and are more difficult to manage with standard dietary advice and toilet routines.
The doctor will always assess whether the symptoms are consistent with the usual pattern of functional constipation.
How Is Constipation Diagnosed in Children?
The diagnosis is primarily based on a discussion with the parents about the child's bowel movement patterns, symptoms and how long the problem has been present. In the vast majority of cases, this is sufficient, and blood tests, X-rays or other imaging examinations are not necessary.
The doctor will typically ask how often the child has bowel movements, what the stools look like, whether passing stools causes pain and when the problems began.
A physical examination may also be performed, including an assessment of the abdomen, to determine whether stool has accumulated in the intestine.
Further examinations are only considered if the symptoms do not fit the typical pattern or if treatment does not work as expected.
Can Constipation in Children Resolve Without Treatment?
Mild and short-term cases can often resolve on their own or with simple changes to diet and daily habits.
However, more persistent or severe constipation often requires structured treatment over a longer period, as the cycle of withholding stools can otherwise be difficult to break.
Treatment is always tailored to the individual child and depends on how severe the constipation is and how long it has been present.
In mild cases, adjusting the diet to include more fibre — such as whole grains, vegetables and fruit — and ensuring that the child drinks enough water may be sufficient.
For older children, establishing regular toilet routines, where they sit on the toilet at the same times each day without feeling rushed, can also make a significant difference.
If dietary changes and toilet routines are not enough, the doctor may assess whether a laxative is needed to soften the stool and make it easier to pass.
Such treatment should always be undertaken in consultation with a doctor, as it is often necessary to continue treatment for an extended period to fully break the pattern of stool withholding.
How Long Does Treatment for Constipation in Children Take?
Treatment may continue for several months, and it is common for constipation to return periodically, even after a good initial response.
The most important goal is to break the cycle of withholding stools and painful bowel movements so that the child regains confidence that going to the toilet will not hurt.
It is also important not to stop treatment too early.
When Should You Seek Medical Advice for Your Child's Constipation?
It is a good idea to have your child assessed by a doctor if constipation has lasted for more than a couple of weeks, if your child is experiencing severe pain or appears significantly unwell, or if there is blood in the stool.
Other signs that should be assessed by a doctor include:
- Your child is losing weight or is not growing and developing as expected.
- A child who was previously toilet-trained begins having stool accidents.
- Symptoms begin very early in infancy.
- You are uncertain as a parent or feel that something is not right.
If you are unsure whether your child's symptoms require medical assessment, it is always a good idea to contact a doctor or health visitor.
Treatment at Charlottenlund Privathospital
At Charlottenlund Privathospital, your child can receive a thorough assessment of abdominal symptoms by a medical specialist.
We listen to your concerns, review your child's symptoms and bowel movement patterns, and work with you to develop a plan for managing constipation, focusing on what works best for your family and your child's individual needs.
Book an appointment online if you would like your child to be assessed by a specialist.
Experience and Expertise at Charlottenlund Privathospital
At Charlottenlund Privathospital, children with constipation are assessed by specialists in paediatrics.
The diagnostic assessment is based on a thorough discussion of the child's bowel movement patterns and symptoms. Treatment is tailored individually, with a focus on diet, toilet habits and, where necessary, medication to soften the stools.
You can find an overview of all departments on our departments page.
Sources:
- Danish Paediatric Society:
Constipation and Faecal Incontinence in Children and Adolescents (2025).
Frequently Asked Questions
How often should a child have a bowel movement?
There is a wide range of normal variation. Many children have a bowel movement once or twice a day, but some only have it every two or three days without it being a problem if the stool is soft and comes out without difficulty.
What are the signs of constipation in children?
Typical signs are hard, lumpy stools, pain when going to the toilet, abdominal pain, decreased appetite and the child avoiding going to the toilet. Some children also have bowel movements in their pants.
Can constipation cause stomach aches in children?
Yes, constipation is a common cause of stomach pain in children, and the pain typically goes away quickly when the child has a bowel movement.
What can I do myself if my child is constipated?
You can increase the amount of fiber in the diet with, for example, vegetables, fruit and whole grains, make sure the child drinks enough water, and help with regular toilet times without time pressure.
Is constipation in children dangerous?
Constipation is uncomfortable but rarely dangerous. However, in rare cases it can be a sign of an underlying condition, so prolonged or severe constipation should always be evaluated by a doctor.
Why is my child holding back stool?
Often because the child has previously had a painful bowel movement and is therefore afraid that it will hurt again. This creates a vicious cycle where the stool becomes harder if it is held back.
What causes bowel accidents in a previously clean child?
This could be a sign of constipation, where loose stools are seeping past a buildup of hard stool in the intestines. It should always be evaluated by a doctor.
Should my child take medicine for constipation?
It depends on the severity of the constipation. In mild cases, changes in diet and toilet habits may be sufficient, while other children need a laxative for a period of time. This is assessed individually by the doctor.
How long does it take to treat constipation in a child?
Treatment can take several months, and it is common for constipation to return periodically. A good result often requires continued focus on diet, habits and possible medication over a longer period of time.
Can constipation in children be caused by diet?
Too little fiber and too little water intake can contribute to constipation. It is also seen more often when there are changes in diet, such as transitioning to solid foods. Any dietary changes should be discussed with a doctor.