Growing Pains

In this fortnightly column, renowned paediatrician Dr Anupam Sibal will help young parents resolve dilemmas

- DR ANUPAM SIBAL

My three-year-old used to pass one motion every day. For the last four months, the motion has happened every other day or sometimes after 3 days. He also complains of pain. How do I deal with it?

Constipation in children usually means passing stools less frequently than expected, having hard or painful bowel movements or sometimes holding stools to avoid discomfort. The commonest type of constipation is functional constipation, which means there is no structural disease causing it. Rather, it is about how the bowel works and how the child responds to stooling.

Functional constipation is diagnosed when a child has constipation without any underlying disease or structural problem and at least two of the following are present: passing stools fewer than two times a week, trying to hold back stools, passing hard or painful stools, passing very large stools or having a large amount of stool felt inside the rectum. In toilet-trained children, stool soiling in the underwear may also occur. These symptoms must continue for at least one month in children for it to be called functional constipation. Children with a history and examination that suggest functional constipation may not require any specific testing.