Constipation is a common problem in children. The symptoms may be mild, and parents may not recognize it as a problem until it becomes chronic, affecting health, growth, learning, and daily activities.

Constipation can occur when babies start complementary foods, typically around 6 months of age. It may result from improper feeding or digestive issues. Incomplete or unsuccessful toilet training is another factor that can cause constipation in toddlers. In this age group, constipation is often characterized by hard stools and painful defecation, which may lead to withholding behavior and chronic constipation. For school-age children, constipation may be related to a lack of fiber in the diet and insufficient toilet time.

If constipation begins as early as the first few months of life, further investigations are necessary to identify any congenital abnormalities, such as imperforate anus, anal stenosis, Hirschsprung disease, or conditions like neurological disorders or hypothyroidism.

In addition to physical examinations, diagnostic tests such as barium enema, anorectal manometry, or MRI defecography may be required.

The main treatment for constipation includes dietary and behavioral modifications, along with toilet training. Laxatives may be needed in some cases. For patients with abnormal muscle function during defecation, biofeedback training can help children learn how to evacuate and coordinate their bowel movements correctly and naturally.


Dr. Thanita Thammarakcharoen
Pediatric Gastroenterology