Constipation in Kids: A Parent’s Guide to Safe, Effective Bowel Management

If your child is struggling with constipation, you’re not alone—and you’re not doing anything wrong. Constipation is incredibly common in children, but understanding how to treat it effectively can feel overwhelming.

As a pediatric pelvic floor physical therapist, I often remind families that treating constipation isn’t about a quick fix—it’s about creating a consistent, supportive plan that helps the body return to normal function.

What Is the Goal for Healthy Bowel Movements?

The goal is simple (but important):

👉 One soft, easy-to-pass stool daily👉 Ideally Type 4–5 on the Bristol Stool Scale

Why does this matter?

When stool is hard or infrequent, the rectum can stretch over time. This reduces your child’s ability to feel the urge to go and to empty effectively, which can lead to:

• Stool withholding

• Accidents (encopresis)

• Bladder irritation and urinary issues

Restoring regular, soft bowel movements helps the rectum return to normal size, sensitivity and squeeze.

Knowing what to take to help your child's bowel issues can be overwhelming!

The 3 Main Strategies for Managing Constipation in Kids

Think of bowel management in three key categories:

1. Keep Stool Soft

This is the foundation of treatment.

💧 Dietary Approaches

• Increase water intake

• Focus on soluble fiber:

  • Oats

  • Beans

  • Chia seeds

  • Fruits

• Consider magnesium-rich foods or supplements

💊 Stool Softeners

These help stool hold onto water so it’s easier to pass.

• Docusate sodium (Colace, Dulcolax softener)

• Works by drawing water and fats into the stool

👉 Best for: Kids with hard, painful stools

💧 Osmotic Laxatives

These pull water into the stool to soften and increase volume.

Common options:

• Polyethylene glycol (Miralax)

• Magnesium hydroxide (Pedia-Lax, Dulcolax chews)

• Lactulose

• Magnesium citrate

👉 Best for:

• Chronic constipation in kids

• Long-term stool softening

2. Keep Stool Moving (From Above)

Sometimes soft stool isn’t enough—your child’s body needs help moving it through the intestines.

🥦 Dietary & Natural Supports

• Fiber supplements (Metamucil, Citrucel, gummies)

• Insoluble fiber (whole grains, fruits, vegetables)

• Warm beverages (tea, coffee for older kids/adults)

• “Smooth Move” tea (used cautiously and age-appropriately)

💊 Stimulant Laxatives

These trigger bowel contractions.

• Senna (Ex-Lax)

• Bisacodyl (Dulcolax)

👉 Best for:

• Slow motility

• Children who are withholding

• Medium-term use alongside stool softeners

3. Help Stool Exit (From Below)

When stool is stuck in the rectum, sometimes we need more direct help.

🚽 Enemas

Used to empty the rectum quickly.

Options include:

• Saline enemas (Fleet)

• Docusate mini enemas (Enemeez)

• Mineral or olive oil (overnight softening)

🚽 Suppositories

Stimulate rectal emptying.

• Glycerin (gentle option, can be liquid or solid form)

• Bisacodyl

👉 Best for:

• Younger children/toddlers or older children who can participate in managing their own care

• Difficulty initiating a bowel movement

• Stool buildup or impaction - Clearing large amounts of stool to decrease cramping with stimulant laxative

• Ensuring the bowel gets empty on a regular basis

Medication is not the only thing that helps bowel function - movement helps too!

Don’t Forget: The Body Matters Too

Medication is just one piece of the puzzle.

Movement-Based Strategies That Make a BIG Difference in Kids with Constipation

🤲 Abdominal Massage

• Helps stimulate bowel movement through the colon

• Especially helpful for younger kids

🧘 Stretching & Positioning

• Squatting position when on toilet(feet supported!)

• Gentle trunk movement

• Rotational or twisting stretches

💪 Core & Pelvic Floor Coordination

• Proper abdominal pressure

• Relaxation of the pelvic floor

• Breathing mechanics

This is where pelvic floor physical therapy can be incredibly helpful—especially for kids who:

• Withhold stool

• Have painful bowel movements

• Struggle despite medications

Why a Combined Approach to Managing Constipation in Kids Works Best

Many parents try one thing at a time—but constipation often requires a layered approach:

✔ Soften the stool ✔ Keep it moving ✔ Help the body empty effectively

Consistency is key. This process can take months, but with the right plan, improvement is absolutely achievable.

When Should You Seek Help?

Talk to your pediatrician or a pelvic floor therapist if your child has:

• Fewer than 3 bowel movements per week

• Painful or large stools

• Stool accidents

• Frequent belly pain

• Ongoing constipation despite treatment

Final Thoughts for Parents

Constipation can be frustrating—for both you and your child. But it’s also very treatable with the right combination of support.

You don’t have to figure it out alone. Working with a PT and a supportive doctor can give you the tools and resources to coach you and your child to success!

With the right plan, you can help your child:

• Feel better

• Regain body awareness

• Build lifelong healthy bowel habits

  If you are in the Huntersville area, consider a consultation at Fundamental Physical Therapy to find the right strategy to overcome your child's constipation challenges.