Families Bowel problems How to treat constipation For most children, constipation can be successfully treated. However, in some cases it can be a long and difficult journey; the child may need on-going support from health professionals and a lot of patience and encouragement from parents and carers. If your child is showing signs of constipation, you should take them to the GP as soon as possible. The quicker they’re assessed by the doctor, the easier it will be to treat the problem. Left untreated, constipation can become chronic, which is when it lasts more than eight weeks. The GP’s assessment The GP will determine if your child has a poo blockage in their bowel by examining the abdomen. They’ll ask some questions about your child’s pooing patterns and do a general examination to rule out any underlying causes. If underlying causes are found, your child will be referred to a specialist health professional for further tests. If there are no underlying medical causes, this is called idiopathic constipation. The National Institute for Health and Care Excellence (NICE) recommends laxative treatment for idiopathic constipation that has lasted more than a few days (See NICE guidelines on constipation in children and young people). The laxatives prescribed by the GP will help clear out your child’s bowels of the built-up poo and help them start pooing regularly again. Depending on the age of your child and the severity of their constipation, they will need different types and strengths of laxative. Laxative treatment The NICE guidelines provide information on how to take laxatives correctly and explain how they clear out, or disimpact, the bowel. You can also read our factsheets: A Parent's Guide to Disimpaction and How to Prepare Macrogol Laxatives. Children’s laxatives are normally in powder form which should be mixed with water and then added to drinks or food. Macrogol laxatives such as Movicol Paediatric Plain work by getting more water into the bowel, which keeps poos soft and easier to pass. Stimulant laxatives such as sodium picosulfate, bisacodyl, senna and docusate sodium encourage the bowel to push the poos out. Children who don’t have an impacted rectum will be prescribed a ‘maintenance therapy’ using a macrogol laxative. If this doesn’t get the poo moving, a stimulant laxative might be added. If the rectum is impacted, higher doses of laxatives are needed which will fully clear out the bowel. You know the bowel is cleared out once the child passes brown water. Many parents worry that the laxatives make the soiling problem worse, but it’s important that the blockage is fully cleared. Stopping the medication too soon can result in the constipation recurring. After this, a smaller, daily maintenance dose of laxatives will be required. The aim of the maintenance dose is to prevent poos from building up again. If the maintenance dose isn’t followed, and the stretched rectum is not allowed to gradually return to its normal size, your child might become constipated again. Laxative treatment may need to be taken for several months and shouldn’t be stopped abruptly. Some children might need it for several years and a minority will require long-term laxative treatment. Changes to diet You may need to make some changes to your child’s diet alongside the laxative treatment to ensure they’re getting enough fibre and fluids. For more information see our information on how to prevent constipation. Developing a good toileting routine Children who have chronic constipation often have trouble recognising when they need to go to the loo. This is because they lose the sensation of needing to do a poo when the rectum is stretched. In addition to the laxative treatment, you should get your child into a good toileting routine. Encourage them to sit on the toilet at regular times each day, ideally 20-30 minutes after a meal. For more information look at our tips for establishing a good toilet routine.