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Children with Severe Constipation Require Treatment

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children who are severely constipated need treatment Andrey Armyagov/PhotoSpin

During potty training and beyond, parents of young children need to be on the lookout for chronic constipation.

That’s the message from Dr. Maria Oliva-Hemker, director of pediatric gastroenterology and nutrition at Johns Hopkins Children’s Center in Baltimore.

The center runs a multidisciplinary clinic offering medical and behavioral therapy for chronic constipation affecting children.

Doctors at the center are troubled by a possible rise in the more serious cases of pediatric constipation, not just the mild constipation that is normal in childhood.

They say the fault could lie with children’s lack of physical activity, inadequate water intake and diets too low in fiber.

Outside of children’s habits, there could be other factors leading to a rise in severe cases, including delays in diagnosis, Oliva-Hemker said.

“The reality is that too many children are either not treated at all, start treatment too late or are treated inadequately, leading to persistent, severe and chronic constipation,” Oliva-Hemker said in a Johns Hopkins media release.

A columnist for the Cleveland Plain Dealer recently researched severe constipation in kids and was told by pediatric gastroenterologists that 25 percent to 30 percent of young children struggle with constipation.

The columnist, Sarah Jane Tribble, noted that the condition can lead to emotional scars. On the other hand, psychological concerns such as fear of using the toilet can lead to severe constipation.

In the early stages of potty training their children, parents need to keep the experience positive and refrain from reprimands,Tribble learned.

Pediatric gastroenterologists that she interviewed said to be on the lookout for bowel movements that are pellet-like and/or bowel movements that occur less than twice a week.

Other signs that warrant a visit to the doctor’s office include straining with bowel movements, a feeling that the bowel is not empty, and behavior that indicates the child is resistant to “going number two.”

The first line of treatment for chronic constipation, the clinic said, is over-the-counter osmotic products like polyethylene glycol-electrolytes, sold in powder form.

They are not laxatives and are not habit-forming, but they do increase water in the colon to promote bowel movements. A doctor needs to monitor the dose and duration of the osmotic.

Preventive measures against childhood constipation include:

- Drinking plenty of water

- Limiting dairy products if they seem to make a difference in bathroom habits

- Staying physically active

- Favoring fruits and vegetables over foods high in fat and sugar, and processed foods

- Helping the child understand that “holding it in” or ignoring the urge to have a bowel movement makes the problem worse

“Severe constipation needs to be treated early and aggressively,” Oliva-Hemker says. “And no amount of fiber or prune juice will help a child with serious chronic constipation.”

In addition to seeking help from a pediatrician, parents might also want to consider an appointment with a pediatric gastroenterologist.

As the Healthy Children website of the American Academy of Pediatrics explains, pediatric gastroenterologists see children for conditions ranging from colon and liver health to abdominal pain to food intolerances.

If needed, they can perform a variety of endoscopic procedures and specialized colonoscopies, the website noted, adding that digestive, liver and nutritional problems in children are often quite different from those seen in adults.

Pediatric gastroenterologists treat infants, children and teens.


Tribble, Sarah Jane. “Chronic constipation easy to overlook, hurts children.” Cleveland Plain Dealer. Web. 22 October 2012.

“Plugged Up: Doctors See Signs of Worsening Constipation in Children.” Johns Hopkins Children’s Center. Web. 22 October 2012.

“What is a Pediatric Gastroenterologist?” HealthyChildren.org. Web. 22 October 2012.

Reviewed October 23, 2012
Michele Blacksberg RN
Edited by Jody Smith

Add a Comment7 Comments

EmpowHER Guest

My son is drinking Enfamil.. and so far he does not encounter any problem too. May take this into consideration maybe?

April 4, 2015 - 10:40pm
EmpowHER Guest
Anonymous (reply to Anonymous)

I would still rather prefer mamil than enfamil.. because my dd cannot take it enfamil as too sweet for her... and I found that Mamil just good for my dd

April 6, 2015 - 11:29pm
EmpowHER Guest

Based on my experience, child's constipation usually caused by not suitable formula. My colleague ask me to give a try on Mamil for a week and it really helps for my child constipation problem. Thanks to Mamil my child no longer cry during bowel movement cos it contains highest lvl of DHA and no sugar at all. These ingredients helps for constipation problem.

April 2, 2015 - 8:28pm
EmpowHER Guest

Aiya a lot these remedies cannot work one la, u all shud find out properly first before testing it out so don’t need waste time. I tried all these remedies before la, especially those herbs. Ended up my LO being in the hospital for a week. So better don’t simply try remedies before getting proper medical advise.

April 2, 2015 - 6:10am
EmpowHER Guest

Im totally agree with you, my son always gets me in trouble whenever he is facing constipation problem. My past experiences is the formula should be too "heatty " for my son. So, he will face constipation problem. You can try eating more fruits and drink plenty of water. =) Cheers.

April 1, 2015 - 8:04am
EmpowHER Guest

My son does not encounter any constipation prob till last 2 weeks he cried whenever there was bowel movement.. Then i started to realize he is in pain and having constipation problem. I checked online for constipation child treatment and there are many causes for child constipation. Any formula can help for child constipation?

March 31, 2015 - 6:01am
EmpowHER Guest

thankd for information

March 30, 2015 - 7:14pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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