Constipation in Children
Constipation is one of the most common paediatric gastrointestinal complaints, affecting up to 30% of children. It causes significant distress to both children and parents. At Dashvanth Healthcare Delhi, our paediatric team provides evidence-based constipation management.
Definition
Constipation in children: fewer than 3 bowel movements per week, hard or painful stools, stool withholding behaviour, faecal soiling (encopresis from overflow).
Causes
- Low-fibre diet (most common)
- Insufficient fluid intake
- Toilet training difficulties
- Painful defecation creating a withholding cycle
- Change in routine (school toilet anxiety)
- Cow’s milk protein intolerance
- Rarely: Hirschsprung’s disease, hypothyroidism, spinal issues
Red Flags (Suggest Organic Cause)
- Onset in first month of life
- Passing meconium after 48 hours
- Ribbon-like stools
- Severe abdominal distension
- Blood in stool not explained by fissure
- Neurological abnormalities
Treatment
Dietary Modification
- Increase fibre: fruits, vegetables, whole grains, pulses
- Adequate fluid intake (water, not sugary drinks)
- Reduce cow’s milk if intake is excessive
Laxatives
- PEG (Polyethylene Glycol/Movicol): First-line, safe and effective. Initial disimpaction then maintenance dose.
- Lactulose: Osmotic laxative, widely used.
- Senna: Stimulant laxative for short-term use.
Behavioural Strategies
- Regular toilet sitting after meals (utilising gastrocolic reflex)
- Positive reinforcement, reward charts
- Reducing toilet anxiety
Expert paediatric constipation management at Dashvanth Healthcare Delhi: 011-41670042
