3 Common Types of Constipation in Kids

Constipation is a common concern among kids and can manifest in various forms, each with different characteristics and underlying causes. Understanding the differences between each type of constipation is to finding the right solutions for your kiddos. Let's explore three prevalent types of constipation in kids and review insights from current research that helps parents better understand how to support their kids struggling with constipation.

Distinguishing Constipation Types in Kids

Constipation in kids can be commonly categorized into these types:

1. Functional Constipation

Functional constipation has no underlying organic cause, which is the case in up to 95% of kids struggling with constipation [5]. This is the most common type of constipation in kids, often characterized by infrequent bowel movements, hard stools, and difficulty passing stool [1]. Underlying causes of functional constipation may include:

• Dietary factors, specifically a low fiber intake

• Inadequate fluid intake

• Lack of physical activity

• Psychological factors like stress or anxiety

2. Secondary Constipation

Secondary causes of constipation stems from underlying medical conditions or external factors. For example, neurological or myopathic disorders such as multiple sclerosis can lead to symptoms from constipation such as hard stools or irregularity. Other causes of constipation from secondary factors include:

• Illnesses

• Medications

• Changes in routine or diet / hydration levels

Data from studies show us that certain medications, especially those impacting the nervous system, may lead to secondary constipation as a side effect in pediatric patients [6]. For more information regarding the types of medications that can lead to constipation in kids, check out our blog: 3 Medications that Can Cause Constipation in Kids.

3. Psychogenic Constipation

Psychogenic constipation, also known as functional non-retentive fecal soiling, is often related to both psychological or physiological factors. In addition, emotional stress can also contribute to this type of constipation in kids. Research in the Journal of Pediatric Gastroenterology and Nutrition suggests a strong connection between emotional stress and bowel habits in kids. Causes of psychogenic constipation include:

• Anxiety around pooping

• Fear or withholding

• Trauma from negative potty experiences

Management Strategies for Kids Constipation

• Dietary Adjustments: Introduce fiber-rich foods, adequate hydration, and a balanced diet to promote regular bowel movements. Prebiotics and probiotics can also help rebuild and maintain a balanced microbiome to help with happier digestion.

• Physical Activity: Encourage daily physical activity and playtime to stimulate bowel movements and improve gut motility [7].

• Establishing Routine: Creating a consistent toilet routine and a comfortable environment for bowel movements can help manage symptoms from constipation in kids.

References:

[1] Koppen, I. J., Vriesman, M. H., Saps, M., Rajindrajith, S., Shi, X., van Etten-Jamaludin, F. S., Di Lorenzo, C., Benninga, M. A., & Tabbers, M. M. (2016). Prevalence of Functional Defecation Disorders in Children: A Systematic Review and Meta-Analysis. The Journal of Pediatrics, 182, 133–143.e4.

[2] Tabbers, M. M., DiLorenzo, C., Berger, M. Y., Faure, C., Langendam, M. W., Nurko, S., Staiano, A., Vandenplas, Y., & Benninga, M. A. (2014). Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. Journal of Pediatric Gastroenterology and Nutrition, 58(2), 258–274.

[3] Borowitz, S. M., Cox, D. J., Tam, A., & Ritterband, L. M. (2009). Sustained-release vs. immediate-release laxatives for children with constipation. The Journal of Pediatrics, 154(5), 698–701.

[4] Closa-Monasterolo R, Ferré N, Castillejo-DeVillasante G, Luque V, Gispert-Llaurado M, Zaragoza-Jordana M, Theis S, Escribano J. The use of inulin-type fructans improves stool consistency in constipated children. A randomised clinical trial: pilot study. Int J Food Sci Nutr. 2017 Aug;68(5):587-594. doi: 10.1080/09637486.2016.1263605. Epub 2016 Dec 8. PMID: 27931142.

[5] Allen P, Setya A, Lawrence VN. Pediatric Functional Constipation. 2022 Aug 19. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30725722.

[6] Rao et al. (2016). Pediatric Constipation: Evaluation and Treatment. Journal of Neurogastroenterology and Motility.

[7] Gao R, Tao Y, Zhou C, Li J, Wang X, Chen L, Li F, Guo L. Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials. Scand J Gastroenterol. 2019 Feb;54(2):169-177. doi: 10.1080/00365521.2019.1568544. Epub 2019 Mar 7. PMID: 30843436.