Constipation refers to 

  • Hard, dry stools (poo) i.e. poo that is like a hard pebble or a lumpy stool (see the stool chart below) 
  • Stools that are hard to push out, so that straining and pushing hard occurs
  • Infrequent passing of stools (people vary in their bowels habits. Some will need to empty their bowels three times per day whereas others do a poo three times per week.)

Why is constipation a problem?

When a child is constipated they may have a lot of poo in their bowel. This can mean that their tummy can feel very sore and they can be irritable and not want to eat. 

Prolonged constipation can lead to overstretching of the bowel and rectum. This overstretching can result in loss of sensation in the bowel and rectum, so that the child is unable to feel when they need to go to the toilet to do a poo.  

When a child is constipated, loose or soft stools can escape around the harder poo, and this can result in diarrhoea or soiling. Many parents find it frustrating to find poo smeared on their child’s underwear. Despite becoming quite smelly, often the child does not have a sensation of having soiled their underwear nor or they aware of the smell (as they have become used to it).  

It can be painful trying to pass a large stool and sometimes the skin around the anus can tear, resulting in an anal fissure. These can be extremely painful and understandably the child then becomes hesitant to open their bowels again as they fear having another painful experience. This fear causes them to “hold on” and put off going to do a poo. This makes the problem worse as the longer the stool remains in the rectum more water gets drawn out, resulting in a harder, drier, stool that is even more painful to pass. 

In severe cases the stools can block up the bowel resulting in faecal (poo) impaction. It is vital to address this urgently. Medical advice and treatment should be sought immediately either from a family doctor or hospital emergency department. Some children may require treatment in hospital to clear the blockage and delaying treatment may cause the child to become seriously unwell. 

Preventing and treating constipation in children

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Kylie – parent of a child that wets the bed 

Kylie rang our service as she was concerned about her five-year-old daughter, Mia, who was wetting the bed. Kylie had tried limiting Mia’s drinks in the late afternoon and evening and was also getting up at night to wake Mia and take her to the toilet.

Our advisor explained that it may take children until they around 5 ½ years old before they gain bladder control during sleep. Kylie was advised to encourage Mia to drink well throughout the day and was cautioned against cutting out drinks in the afternoon and early evening. Kylie was discouraged from waking Mia at night to take her to the toilet. Kylie was provided with information on obtaining a referral from Mia’s doctor to a bedwetting clinic if Mia continues to wet the bed past 5 ½ years of age.

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Anastasiya’s story

“As a mum of two young children, I have experienced the joys of two pregnancies and postpartum recoveries. I was shocked after the birth of my first child to discover that my pelvic floor muscles had become weak. I sought advice from Bladder and Bowel Health Australia and learnt the importance of exercising these muscles. This knowledge helped, and because I was better informed second time around, I have now fully restored the dignity of my body and truly enjoyed the changes - and my motherhood. Thank you, Bladder and Bowel Health Australia, for informing young families about bladder and bowel health issues.” 

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Doreen – carer of her husband who has dementia 

Doreen was becoming exhausted caring for her husband Tom, who has dementia. Tom was not always making it to the toilet on time and needed his trousers to be changed several times a day. Every day Doreen was also washing bedlinen and the four towels that Tom was laying on at night as he was soaking through his pull-up pants. 

Tom was receiving a high-level Home Care Package, and Doreen was able to arrange with their provider for some of Tom’s package to be allocated to funding continence assessment and management.  

Our advisor went to Tom’s home and conducted a thorough continence assessment. A continence management plan was developed with input from Doreen, and appropriate incontinence aids and linen protection were organised. Doreen is relieved that Tom’s incontinence has reduced, and her washing load has lessened. Doreen is now confident that she can continue caring for Tom in their home. 

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Gary – experiencing leakage after his recent prostate surgery 

Gary met with one of our Bladder and Bowel Health advisors, as he was concerned about his urine leakage that was persisting after his radical prostatectomy five weeks earlier.   

Gary discussed his concerns with the advisor and was reassured that he was making good progress towards regaining bladder control. This reinforced the information he had received from his urologist. Gary was encouraged to switch to a smaller incontinence pad rather than continuing to wear the pull- up incontinence pants he had worn since his surgery. The advisor arranged some smaller pads for him to trial and provided details on where he could buy them close to his home. 

Gary was encouraged to drink plenty of fluid (particularly water) and to increase his fruit and vegetable intake to avoid constipation. Gary was uncertain if his pelvic floor muscles were working properly and he was referred to a pelvic floor physiotherapist. Gary left the clinic in a brighter frame of mind, confident that he was improving and had clear strategies to further support his recovery.