For many children there is no underlying physical reason for what is causing their constipation. This is known as idiopathic or functional constipation.

Idiopathic constipation most commonly develops in children between 2 and 4 years old and has various possible causes including: 

  • Withholding poo (also called ‘stool withholding’, which is when a child avoids emptying their bowels)
  • Fear of the toilet (sometimes associated with pain or discomfort)
  • Lack of a toilet routine (some children have such busy lives that it can be difficult to find time to sit and relax on the toilet each day)
  • Resistance to potty training and an insistence that a nappy be put on to poo in
  • An unbalanced diet
  • Low fluid intake
  • A change in routine
  • Anxiety and emotional upset (for example when starting nursery or potty training)
  • Some medications

When an underlying illness or condition has caused the constipation it is described as constipation with an underlying organic cause

The following symptoms or signs could indicate that an underlying illness is the cause:

  • Vomiting *
  • Weight loss or failure to gain weight *
  • A swollen, stretched tummy *
  • Severe pain *
  • A baby that does not pass its first stool (called meconium) within the first 48 hours of life
  • Abnormalities of the anus
  • Sores or ulcers near the anus *
  • Neurological problems (such as weak or paralysed legs)
  • Excessive thirst
  • Urinary symptoms *
  • Very pale-coloured poos

* These symptoms can also be caused by idiopathic/functional constipation however.

As there may be very little to see to suggest that that child has an underlying condition which is causing their bowel problems, it's very important for all children with constipation to have a physical examination. 

For more information and help with this, see our continence assessment form and the constipation flowchart of the Children's Continence Pathway

Follow this link for information about spotting the signs of constipation.