Chronic Constipation in Children: Signs, Symptoms, and Treatment Parents Should Know

by Lise Leahy RD CDE, Registered Dietitian

Constipation Is More Common Than You Think

Chronic constipation in children is one of the most common digestive issues treated in pediatrics. It can affect your child's comfort, mood, appetite, growth and their self-esteem — but the good news is that it’s very treatable.

Whether you're noticing belly pain, irregular stools, or confusing "diarrhea-like" accidents, understanding constipation is the first step toward helping your child.

What Is Chronic Constipation in Children?

Chronic functional constipation happens when a child regularly struggles to pass stool without an underlying medical condition. It’s often caused by pain, stool withholding, diet, or changes in routine.

Signs your child may be constipated:

• Fewer than three bowel movements per week

• Hard, dry, or very large stools, with some liquid stool at times

• Pain while pooping

• Stool accidents or soiling

Common Symptoms of Constipation in Children

Look out for these symptoms:

• Hard, pellet-like stools

• Pain or straining during bowel movements

• Belly pain or bloating

• Avoiding the toilet

• Liquid stool accidents (often mistaken for diarrhea)

Overflow Soiling: A Common But Misunderstood Sign

Overflow soiling occurs when liquid stool leaks around hard, impacted stool. It often looks like diarrhea, but it’s actually a symptom of severe constipation.

Children may have accidents throughout the day — not because they’re not toilet-trained, but because their bowel is stretched and can’t hold back the leaks.

Why Constipation Often Gets Missed

Because chronic constipation develops slowly, many parents miss the early warning signs. Tummy aches, loss of appetite, and stool accidents are often seen as unrelated issues — but they usually trace back to constipation.

Early treatment prevents long-term problems.

Effective Treatment: Using Osmotic Laxatives

An osmotic laxative like polyethylene glycol (PEG 3350) is often the first recommended treatment. Osmotic laxatives pull water into the intestines to soften the stool, making it easier and less painful to pass. Treatment takes time. Be prepared for months of taking this laxative, not days or weeks.

Benefits of osmotic laxatives:

• Safe for long-term use with support from health care professional

• Well-tolerated by children

• No risk of dependency

• Recommended by pediatric guidelines

Other supportive treatments:

• Regular toilet-sitting routines

• A fiber-rich diet and plenty of water

• Encouragement and rewards (no punishment!)

• Ongoing medical support

Why Early Treatment Matters

Ignoring constipation can lead to:

• Worsened stool withholding

• Chronic pain and bloating

• More frequent accidents

• Loss of appetite or poor growth

Getting help early sets your child up for success!

Let Us Help Your Child Feel Better

If you suspect your child is constipated — or you’re unsure about frequent stool accidents — contact us today for expert support.

We’ll work with you to create a personalized, child-friendly plan to get your child or teen back to feeling better.

Click this link to book a call  https://l.bttr.to/yViV4

References

• Candy DCA, Belsey J. Osmotic and stimulant laxatives for the management of childhood constipation. Cochrane Database of Systematic Reviews, 2009.

• Tabbers MM, et al. Evaluation and treatment of functional constipation in infants and children: Evidence-based recommendations. Journal of Pediatric Gastroenterology and Nutrition, 2014.

• NICE Clinical Guideline CG99. Constipation in children and young people: Diagnosis and management.

• Rome Foundation. Rome IV Diagnostic Criteria for Functional Gastrointestinal Disorders.

• American Academy of Pediatrics (AAP). Evaluation and Treatment of Constipation in Children and Adolescents.