For reasons that cannot always be identified, some children have frequent bouts of constipation. Changes in the frequency of bowel movements or changes in the size, shape, or consistency of your child's stools may cause concern. These changes will usually clear up with home treatment.

There are several risk factors that contribute to chronic constipation.

• A crack (fissure) around the anus can make bowel movements painful and cause the child to resist passing stools. This is a common problem that gets worse every time the child passes a large stool.
• A brief illness with poor food intake, fever, and little or no physical activity may upset normal bowel habits.
• Emotional problems or toilet training problems can lead to voluntarily withholding stools. A child may have fought the toilet training process, been pushed too fast, or been punished for having accidents. Struggling with parents for control may cause a child to hold stools back as long as possible.
• A change in environment can cause constipation. At school, children may withhold stools because they are afraid or embarrassed to use school bathrooms, their schedules are too busy for them to take time for a bowel movement, or school schedules interrupt their normal bowel movement time.

It is important to determine the cause of constipation that occurs frequently or is severe. Make sure your child's diet or drinking habits are not the cause. Be sure your child follows a nonconstipating diet for at least one week. In most cases, the constipation will be relieved with a change in diet and increased fluids. However, it is not uncommon for constipation to recur after a long period of normal bowel movements.

If you have developed a plan with your health professional to relieve your child's frequent constipation, follow that plan. If your child's constipation does not get better after home treatment, contact your health professional to determine the cause of your child's constipation.