Constipation and tummy problems in children

What causes constipation and tummy problems in children?

Constipation means pooing less often than usual, or passing hard, painful or pellet-like poos. It is very common in children, especially around potty training and starting school, and most of the time there is no serious underlying disease — this is called idiopathic constipation.

It often starts a vicious circle: one hard, painful poo makes a child hold the next one in, the poo then builds up and gets harder, and pooing becomes even more painful. Children may clench, cross their legs, hide or seem to 'try not to go' — this is the body holding on, not the child being difficult, and it is not their fault. When a large amount of poo builds up, runny poo can leak around it and stain pants (overflow soiling), which is often mistaken for diarrhoea.

Tummy aches in children are also very common and are often linked to constipation, though they can have other causes. The assessment works out whether constipation is the problem, rules out the less common warning signs of something more serious, and sets up effective treatment.

The key messages are reassuring and practical: constipation is treatable, laxatives are the main treatment and are safe to use for as long as needed, they often need to be continued for months to break the cycle, and stopping too soon is the usual reason it comes back. Getting help early makes it easier to sort out.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your treatment

• Keep a simple diary: how often your child poos, whether poos are hard or soft, any pain, any pants-staining, and any tummy aches.
• Note when it started and what was happening then (potty training, starting school, an illness, a change at home).
• Bring your child's red book and a note of their growth if you have it.
• List anything you have already tried, including any laxatives and for how long.
• Note your child's usual drinks and diet, and any foods they avoid.
• Write down your main worries, including any of the warning signs, so they can be addressed.

What happens

The clinician asks about the pattern of poos, pain, pants-staining and tummy aches, and when and how it started. They will usually examine your child's tummy and check growth. A finger examination of the bottom is not routine and is generally avoided in primary care. The aim is to confirm idiopathic constipation and check there are no warning signs of a less common cause.

Treatment usually begins with explanation and reassurance, then laxatives. If a lot of hard poo has built up, a clear-out (disimpaction) with a higher dose for a short time may come first, after which the dose is settled to keep poos soft. Diet, fluids and a calm toilet routine support the medicine.

You should leave understanding that laxatives are safe and often needed for months, how to adjust the dose to get soft poos, and the importance of not stopping too soon. The clinician will also explain the warning signs that mean your child needs to be seen rather than managed at home.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Laxatives such as macrogols are safe for children and are not habit-forming; the bowel does not become 'lazy' from using them. The commonest mistakes are using too low a dose, or stopping too soon once things improve, both of which let constipation come back. The other risk is missing a less common cause: constipation present from the first weeks of life, faltering growth, blood in the stool, a very swollen tummy, leg weakness, or severe pain need a doctor rather than home treatment.

Published figures to discuss

Most childhood constipation responds to treatment, but the exact chance and timing of recovery vary widely with the child, the duration of the problem and how consistently treatment is given. There are no robust single percentages to quote for success or relapse, so we describe the likely course qualitatively and avoid inventing figures.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery from the assessment. 'Afterwards' is about following the treatment plan, giving laxatives time to work, and continuing long enough to break the cycle for good.

• Looser, more frequent poos at first during a clear-out
• Gradual return of soft, comfortable, regular poos
• Soiling improving over weeks as the bowel recovers
• Needing to continue laxatives for months to keep things soft

Aftercare

• Give the laxative every day at the dose advised, and adjust it to keep poos soft and comfortable.
• Do not stop laxatives as soon as things improve — continue for as long as advised, often several months.
• Offer plenty of drinks through the day and a good range of fruit, vegetables and fibre.
• Set up a calm toilet routine: sitting for a few minutes after meals, with feet supported on a step.
• Praise and reward sitting on the toilet, not just producing a poo, and keep it blame-free.
• Keep a diary so you and the clinician can see whether the plan is working.
• Go back if there is no improvement, if you want to reduce treatment, or if any warning sign appears.

• Laxative obtained and the dose plan understood
• A clear plan for how long to continue and how to adjust the dose
• A step or footstool so your child's feet are supported on the toilet
• A simple reward chart for sitting on the toilet
• A drinks-and-fibre plan for the day
• A poo-and-symptom diary
• A note of the warning signs and who to contact

⚠ Get urgent help if…

• A swollen, hard or very tender tummy, or severe tummy pain — seek urgent review; call 999 if your child is very unwell
• Constipation that has been present since the first few weeks of life, or a newborn who did not pass their first poo in the first day or two
• Blood in the poo, or vomiting that is green or persistent
• Faltering growth, weight loss, or a child who seems generally unwell
• Weakness in the legs, changes in walking, or problems with weeing alongside constipation
• Signs of dehydration: very few wet nappies or trips to the toilet, no tears, sunken eyes
• A child who is very drowsy, floppy or hard to wake, or has a non-blanching rash — call 999
• No improvement despite treatment, or constipation that keeps coming straight back

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

Most children do well: with laxatives at the right dose, plenty of fluids, fibre and a calm routine, poos become soft and comfortable, tummy aches ease, and any soiling settles as the bowel recovers. The key to a lasting result is continuing treatment long enough — often several months — and reducing it slowly rather than stopping the moment things improve.

Getting better is not always a straight line; constipation can return after an illness or a change, and treatment may need stepping back up. A good plan treats this as expected, not as failure. A normal assessment does not rule out every future tummy problem, so the warning signs still matter and any of them means seeking review.

Idiopathic constipation is very treatable, but it can be a long-term tendency in some children, especially if treatment is stopped too early. Many children come off laxatives successfully once a comfortable, regular pattern is well established and reduced slowly. Relapses are common around illnesses, holidays or changes in routine, and are best dealt with by restarting treatment promptly.

Related tests, treatments or support

Tummy aches in children are often linked to constipation, but can also relate to diet, anxiety or, less commonly, other conditions, so the assessment considers the whole picture. In babies, feeding problems and reflux can overlap with bowel symptoms. Where soiling and toileting are a struggle, behavioural support and charities such as ERIC can help alongside medical treatment.

Follow-up & long-term care

Follow-up is about checking the plan is working: that poos are soft, soiling is improving and the dose is right, and supporting you to continue long enough and reduce slowly. Children who do not respond, or who have warning signs or symptoms from early infancy, are referred to a paediatrician to look for less common causes.

• Continue laxatives for as long as advised, often several months, and reduce slowly rather than stopping suddenly.
• Keep up fluids, fibre and a calm, regular toilet routine even once things improve.
• Restart or step up treatment early if constipation returns after illness or a change.
• Keep the toilet experience positive and blame-free to prevent holding-on returning.

Repeat, follow-on and what comes next

• Laxative doses are commonly adjusted up or down to keep poos soft.
• Treatment often needs to continue for months, and reducing too soon leads to relapse.
• Constipation can return around illnesses or changes and may need restarting or stepping up.
• A small number of children need referral if they do not respond or have warning signs.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear plan for laxative dose, how long to continue, and how to reduce slowly.
• Practical toileting advice (after meals, feet supported) and a blame-free, reward-based approach.
• A named route back for dose adjustment, relapse or lack of progress.
• Written warning signs and signposting to support such as ERIC where soiling is a struggle.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether it is a single consultation or includes follow-up over time
• The seniority of the clinician (health visitor, GP or paediatrician)
• Whether laxatives are bought over the counter or prescribed
• Whether dietetic or behavioural (toileting) support is included
• Whether referral to a paediatrician is needed for non-responsive or worrying cases
• Any investigations if a less common cause is suspected

• The consultation fee and how long the appointment lasts
• Whether follow-up over the months of treatment is included
• Which laxative is recommended and whether it is prescription or over the counter
• Whether dietetic or toileting support is included
• What happens, and what it costs, if constipation does not improve
• Who to contact, and how urgently, if warning signs appear

On the NHS? Childhood constipation is usually managed on the NHS by a GP or health visitor, with paediatric referral if needed; private paediatric appointments may be used for reassurance, a second opinion or a quicker review.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Is this ordinary (idiopathic) constipation, or are there any warning signs?
• What laxative and dose should we use, and how do I adjust it to keep poos soft?
• Does my child need a clear-out (disimpaction) first?
• How long should we continue treatment, and how do we reduce it safely?
• What can we do about soiling and the toileting battles?
• What should I watch for, and when should I bring my child back?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for constipation and tummy problems in children

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Constipation in children NICE CG99 — Constipation in children and young people NHS England — National clinical constipation pathway for children ERIC — Advice for children with constipation Healthier Together — Constipation in children

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.