About Childhood Constipation - How Constipation Develops

The causes of constipation may differ from child to child and there may be a combination of factors contributing to the development of constipation. Constipation can happen suddenly (for example after a child has been unwell and not eaten or drunk properly for a few days) or it can happen slowly without anyone being aware that it is happening. Passing a stool is mostly not under your child’s voluntary controlThe only part of the process that he or she can control is relaxing the ring of muscle around the anus to let the stools outJust one painful experience of pushing out hard and dry stools can cause him or her to become afraid of passing stools againThis can get them into the habit of avoiding going to the toilet in case it hurtsThey then start to hold in stools by tightening the muscles around the anus to keep it closed which puts off the urge to poo This only makes the problem worse because:The stools start to build up in the child’s bowelThe next time your child gets the urge to go, it's even harder and more painful to push them outYour child may tighten the muscles around the anus in order to put off the urge to go to the toilet for even longerMore and more hard, dry stools build up in your child’s bowels, which are more difficult to push out than soft, moist ones. The build up of stools in the rectum also causes it to stretch and so it is harder for the child to feel the urge to pass a stoolThe child may need to strain and so they learn to tense the muscles making it harder and more painful to relax enough to do a poo making the constipation worseThe child may leak watery stools into their underwear. This happens because large stools get stuck and block the child's bowel. Liquid stools above the blockage flow around it and are passed out without the child knowing this is happening If your child typically passes small, hard stools (like pellets), passes a stool less than two times a week or says that doing a poo hurts, he or she could have chronic constipation. Chronic constipation means constipation that has persisted for some time. Doctors normally consider the constipation to be ‘chronic’ if it has lasted for more than three months. Your child may need treatment to help break this habit, break the vicious circle and prevent the constipation from coming back.