When evaluating a child for constipation, examining their toileting habits in general can be very enlightening. Frequently, the children I see with functional constipation have difficulty prioritizing trips to the bathroom. Children today are bombarded with many distractions, which are far more reinforcing than a trip to the bathroom. Constipated children frequently ignore their body’s signal that they need to poop. They are able to hold their stool in order to not interrupt their activity.
Educating children on how their body produces stool and why they need to poop everyday can help raise the importance of proper toileting in their mind. I also find that as parents we tend to disregard our children’s toileting habits once they are potty trained. Parental involvement in the form of prompting regular trips to the bathroom after meals and inquiring, “Have you pooped today?” can be all that it necessary to get a child’s habits on track. Keeping a calendar in the bathroom to mark frequency of bowel movements can be very helpful as well. Often times just focusing more positive attention on this daily habit can get a child’s toileting on track. If a child is anxious about toileting or if oppositional defiant behavior get in the way of appropriate toileting habits it may be helpful to refer the family to a psychologist or counselor to evaluate extraneous issues that may be getting in the way of good bathroom habits.