When to take your child to the doctor for constipation

Constipation means hard poop that may happen a few times a week or less. When constipated for a long time, it can lead to encopresis, a condition where stool builds up in the colon and rectum, causing it to stretch and lose control of bowel movements. Pooping may also be painful or straining.

“In kids, constipation may also be from holding their stools in due to prior experiences of fear or pain and is especially common during potty training or when just starting school,” says Erik D. Andrewski, MD, pediatric gastroenterologist at Riley Children’s Health.

Signs your child might need medical attention

“Red flag” symptoms, which may include:

• Significant weight loss
• Not pooping within the first 24-48 hours after birth
• Muscle weakness
• A change in the way your child walks
• Lead exposure

Your doctor will evaluate symptoms like belly pain, vomiting, weight loss and diet, and they will want to know when the difficulty of popping started and if it is getting worse or staying the same. This assessment will help determine the severity of the condition.

Your provider may also examine your child’s reflexes and skin changes on the lower back. If they notice anything abnormal, a treatment plan may be recommended.

In some cases, constipation may require emergency treatment, such as when your child develops anal fissure, or a crock or split in the tissues that line your anal canal, causing acute pain and bleeding. Other emergency cases might be required when your child experiences severe abdominal pain or inability to drink enough fluids to stay hydrated.

When to see a pediatric gastroenterologist

Constipation can typically be treated by your primary care provider. However, if you haven't noticed improvement in your child's symptoms or if larger concerns arise, your pediatrician may refer your child to a pediatric gastroenterologist. Referrals are typically made when:

• No improvement after taking medicine consistently for several months
• Constipation is linked to weight loss
• There is concern about an anatomic or structural cause of constipation
• Constipation is so severe it requires admission to the hospital

Expert care at Riley Children’s

Remember, when your child is constipated, your pediatrician can help guide you in the right direction. And as more support is needed, the expert gastroenterology team at Riley Children’s is always here to provide the specialized care and attention your child needs.