The term “idiopathic constipation” means constipation without a known cause. Children with constipation are not able to have a bowel movement on a routine basis. Often it is a very mild problem that can be solved by changes in diet and exercise. But some children suffer from chronic idiopathic constipation. Idiopathic constipation is a very severe condition that calls for high doses of laxatives or medications, rectal enemas and sometimes surgery. Idiopathic constipation can be managed, but not cured.

What Are the Symptoms of Idiopathic Constipation?

Symptoms may start soon after birth or when your child starts eating baby food or solid food. You may also notice symptoms when you start to potty train your child.

Your child may have these symptoms:

• Not having a bowel movement each day
• Bowel movements are hard and small
• May struggle with bowel movements
• Bowel movements may be painful
• May soil their underwear
• Bloating
• Loss of appetite
• Nausea or vomiting

Sometimes the anus may tear when your child is passing a large, hard piece of stool. This cut may reopen each time the child passes more stool. The child then learns that passing stool is painful and tries to avoid it. Over time, they start to hold the stool in, making the problem worse and harder to treat the constipation.

When stool stays inside the intestine longer than 24 hours, the intestine stretches to hold the large amount of stool. The stretched colon then holds more stool, making the constipation worse.

Your child may have soiling or smearing of stool in their underwear. They may get used to having their underwear always dirty. The child may get used to their own odor. The parents must understand that the child often does not notice their own smell.

How Is Idiopathic Constipation Diagnosed?

There are no tests for idiopathic constipation. However, it is vital for your child’s doctor to check for other conditions before saying they have idiopathic constipation. Your child’s doctor will order a contrast enema, a type of X-ray, to find out the degree of constipation. This test will help guide your child’s treatment.

How Can Idiopathic Constipation Be Treated?

The first step is to make sure your child is on a balanced diet with plenty of fluids. Drinking plenty of fluids is very important to help manage constipation. Children with idiopathic constipation often need to take laxatives each day no matter how balanced their diet is. Laxatives are medicine that help the colon contract or squeeze harder to push or move stool through the colon faster. Your child should have at least one bowel movement each day. Having one bowel movement a day will keep the stool from getting impacted and keep your child from soiling.

Your child will go to our one-week outpatient Bowel Management Program. During this program, we are able to start laxative or rectal enema treatment and adjust this daily until we find the routine that works for your child. After the one-week program we will continue to follow your child and help you to manage their constipation. Growth spurts, changes in diet and other medicine can affect your child’s constipation. The Colorectal Center can help you manage your child’s constipation throughout these stages of their life.

Are There Surgical Options for Idiopathic Constipation?

For some children, laxatives are not enough, and a daily rectal enema is not manageable for independence. They may need surgery to remove the part of the intestine that is most stretched. This surgery may help with constipation or decrease the number of laxative that the child needs.

There are other surgical options to help manage idiopathic constipation. One way to help manage constipation if your child is receiving a daily enema, is to discuss self-administering devices (Peristeen, Wellspect) or surgical options of a Malone appendicostomy. Another option to discuss with the surgeon is a sacral nerve stimulator that can help manage constipation with either laxatives or enemas.