• 1 week ago

Constipation and Irritable Bowel Syndrome (IBS) in Children

What Is Constipation in Children?

Constipation is defined as having fewer than 3 bowel movements per week, or passing stools that are hard, dry, or painful. In children, it often involves voluntary stool withholding, especially during potty training or after a painful bowel movement.

The condition can quickly turn into a cycle: withholding stool causes the bowel to stretch, stools become harder, and passing them becomes even more painful—leading to more withholding.

Constipation is one of the most common gastrointestinal problems in children and often has no underlying disease (functional constipation). However, it can still lead to physical discomfort, poor appetite, irritability, and even social anxiety.

Signs of Constipation in Children

  • Less than two bowel movements per week
  • Hard, pebble-like stools
  • Straining, pain, or crying during bowel movements
  • Bloated belly, decreased appetite
  • Stool accidents (soiling) in underwear
  • Avoiding or resisting going to the toilet
  • Behavioral issues linked to discomfort

What Causes Constipation?

  • Low fiber and fluid intake
  • Delaying or avoiding toilet use, especially at school
  • Early or stressful potty training
  • Lack of physical activity
  • Emotional stress, including changes in routine or environment
  • Rarely: hypothyroidism, Hirschsprung disease, anatomical issues

What Is Irritable Bowel Syndrome (IBS)?

IBS is a functional gastrointestinal disorder with no structural abnormality but ongoing symptoms such as abdominal pain, altered stool frequency, or consistency, often triggered by stress or certain foods.

IBS typically appears in school-aged children and is non-dangerous but disruptive. It is associated with gut hypersensitivity—the intestines overreact to normal stimuli like gas or stretching.

Symptoms of IBS in Children

  • Recurrent abdominal pain (especially around the navel)
  • Relief of pain after bowel movements
  • Changes in stool frequency (too often or too infrequent)
  • Alternating constipation and diarrhea
  • Bloating and gas
  • Symptoms lasting at least 8 weeks
  • No weight loss, fever, or blood in stool

These features help distinguish IBS from more serious digestive diseases.

Diagnostic Process

Diagnosis begins with a detailed medical history and physical exam. Most cases do not require invasive testing.

Possible tests:

  • Blood tests (CBC, CRP, celiac screening)
  • Stool analysis (for blood, parasites, infection)
  • Abdominal ultrasound
  • Growth assessment (to rule out systemic disease)
  • Referral for further testing if red flags are present (e.g., weight loss, nighttime symptoms, rectal bleeding)

Treatment Strategies

For Constipation:

  • Diet: More fiber-rich foods (fruits, vegetables, whole grains)
  • Hydration: Encourage water and limit sugary drinks
  • Toilet training routine: Sit on the toilet for 5–10 minutes after meals
  • Exercise: Increases gut motility
  • Laxatives: Used under medical guidance as a short-term tool

For IBS:

  • Dietary changes: Limit gas-producing or trigger foods (e.g., dairy, artificial sweeteners)
  • Stress management: Address school, social, or family-related stress
  • Regular eating and sleeping schedules
  • Probiotics: May help with bowel regularity and discomfort
  • Medication: Rarely needed unless symptoms are severe

Care and Monitoring with Dr. Ekin Pasinlioğlu

  • Detailed symptom and growth evaluation
  • Guidance for developing healthy toilet habits
  • Assessment for food sensitivities or anxiety-related symptoms
  • Monitoring and adjusting diet and fluid intake
  • Education for children and parents on body awareness
  • Referrals to gastroenterology or psychology when needed