Constipation in Children

A child who says “I don’t need to go” may actually be trying to tell you they can’t get their poop out. Constipation is very common in children and often hard to spot. When stool stays in the bowel for a long time, it can cause both tummy aches and stool leakage. This is not just about diet; it is also linked to pelvic floor awareness, toilet habits and the balance of the sensory system.

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Chronic Constipation in Children

When Does Constipation Become a Problem?

Not having a bowel movement for more than 3 days, hard stools, straining, stool leakage and tummy pain are among the clearest signs of constipation. If these symptoms continue for weeks, it is considered chronic constipation.

It’s Not Just a Lack of Fiber

Diet matters, but on its own it is not the solution for chronic constipation. Sensory sensitivity, avoiding the toilet and pelvic floor muscle dysfunction are also among the main reasons constipation continues.

Learning to Push Correctly with Physiotherapy

With the right toilet position, diaphragmatic breathing training and relaxation skills, your child relearns how to have a bowel movement. Pelvic floor physiotherapy breaks the cycle and helps restore your child’s confidence and regular bowel habits.

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Common and Treatable

About 10-30% of children experience constipation at some point in their lives. It is more common between ages 4 and 6 and in the period after toilet training.

"His tummy is always bloated and gassy, but he says ‘I don’t need to go.’"

"She only goes to the toilet crying. She’s always scared."

"When he does go, the toilet gets clogged. The stool is very large and hard."

Tabbers MM, Boluyt N, Berger MY, Benninga MA. Constipation in children. BMJ Clin Evid. 2010 Apr 6;2010:0303. PMID: 21718570; PMCID: PMC2907595.

Constipation in Children FAQ

What is constipation, and when does it become a problem?

Constipation means passing stool that is hard, infrequent (usually fewer than 2 times a week) and painful. If it lasts more than 2 weeks and affects your child’s quality of life, it is considered chronic constipation. In some cases, a child may have a bowel movement every day but still not empty their bowels completely. This is one of the things parents miss most often.

What causes constipation in children?

Besides low fiber and water intake, many factors can lead to constipation, including poor toilet habits, pelvic floor muscles that are not working properly, sensory sensitivity and fear of the toilet.

Can constipation in children be fixed with diet alone?

Diet is a very important factor, but in some cases it may not be enough on its own. Toilet habits, pelvic floor rehabilitation, bowel and bladder training and body awareness should also be part of treatment.

My child holds in their poop. Is this normal?

No. Withholding stool makes constipation more chronic and can progress along with symptoms such as tummy pain, gas and loss of appetite. Later on, it can get worse and lead to fecal and urinary incontinence.

Can constipation in children cause urinary incontinence too?

Yes! Stool that builds up in the large intestine can press on the bladder and trigger both daytime and nighttime wetting. That is why regular bowel habits are so important for bladder health.

Is constipation in children psychological?

Yes, children who have had a traumatic toilet experience (for example, those who have had bowel problems since infancy or who struggle to poop in the toilet) may deliberately hold in their stool. Over time, however, this withholding turns into a physical problem. The muscles they use to hold in stool are the pelvic floor muscles, and this withholding can eventually lead to pelvic floor muscle dysfunction.

How does physiotherapy help with constipation in children?

With the right toilet position, massage techniques, breathing, pelvic floor awareness and relaxation skills, your child relearns how to have a bowel movement. This breaks the cycle of withholding, straining and painful bowel movements.

When should I see a specialist?

Professional help is a must if your child has had constipation for more than 2 weeks, or has stool leakage, severe tummy pain, loss of appetite or problems that affect their social life.