In order to diagnose your child’s constipation, your doctor or nurse will ask you how long their symptoms have been present and if they have any rectal pain or bleeding.
If you think your child has constipation, it will help your doctor or nurse make a more accurate diagnosis if you fill in a Bowel Record Chart for one or two weeks before your appointment. Please download Bowel Record Chart from here and Children’s Poo Chart from here. The Bowel Chart records details about your child’s bowel habits.
The doctor will also ask you for information on your child’s toilet training and habits, diet and general health and may need to feel the child’s abdomen.
All of this information will help your doctor or nurse find out if constipation is responsible for your child’s symptoms as well as what might be causing it.
Asking about your child’s symptoms
Your doctor or nurse might ask you some questions (such as those below) to find out if your child has constipation.
- How often does your child usually pass a stool? Has this changed recently?
- What do their stools look like? Are they big or small, hard or soft, formed or loose? What colour are they?
- How hard is it for your child to pass a stool? Does your child strain? And how long does it usually take?
- Does your child say it hurts when passing a stool? Does he or she get upset?
- Does your child put off going for a poo?
- Does your child get a tummy ache in between bowel movements? Does it go away after your child has done a poo?
- When did the symptoms begin?
- Is there any blood on the toilet paper or in your child's stools or underwear?
- Does your child always have symptoms, or do they come and go?
- Is your child less hungry than usual?
- Is your child losing weight? Is he or she feverish or vomiting?
- Does your child ever leak very soft or liquid stools into his or her underwear? (If your child is out of nappies)
Working out what's causing the constipation
Your doctor or nurse will then want to work out what is causing the constipation. He or she may ask questions such as this to find out.
- Do other members of your family have constipation?
- What's your child's diet like?
- Has your child's daily routine changed? For example, have they started a new school or been on holiday?
- Is your child taking any medicines or herbal remedies?
- What's your child's behaviour like? Sometimes, holding in stools may be a way to get attention
- To get even more information, your doctor may ask you to keep a diary of what your child eats and how often he or she does a poo
Examining your child
Most children do not require an examination other than a gentle feel of their tummy. However your doctor or nurse may want to look at your child's bottom to see if it is red or cracked and to check for signs of leaking stool. This should only be done with your child's agreement.
Making the diagnosis
After talking to you and examining your child, your doctor or nurse will probably be able to tell if your child has constipation and what is causing it. However, he or she may want to do some tests if he is not sure if your child has constipation, if your child has other symptoms (fever, vomiting or weight loss) or if he thinks that a medical condition could be causing the constipation.
Referral to a hospital specialist
The majority of children with constipation can be treated successfully without having to go to hospital. However in some areas where there is not a service set up in the community for children with constipation your doctor may decide to refer him or her to the hospital.
What will happen next?
If your child's bowels become completely blocked with large, hard stools (called impacted faeces), he or she will need the stool to be removed first in order for the constipation to start to get better.
In most cases this can be done by giving your child special medicine (laxative) which will help soften the stool and enable it to be passed easily.
The NICE Guideline suggests a specific medication to be used first line in children. If the child is over 12 years of age, they can be given MOVICOL. If the child is under 12, they should be given the children's version of this medicine, which is available as a prescription from the doctor. This is the only medicine taken by mouth that is licensed for treating faecal impaction in children. Ask your doctor for more information, and check the NICE Guideline here.
In a small number of cases some children may need to go into hospital to have their bowel cleared out.