Reasons Children Withhold Bowel Movements?

Is your child having problems passing her stool? Do you think she is deliberately withholding her bowel movement? There may be many reasons for this behaviour.

By Ashwin Dewan

Reasons Children Withhold Bowel Movements?

Rajeev Arora is a worried parent. His three-year-old son, Aakash, has been withholding his bowel movement for the past few days. This has led to his health deteriorating. Although, Aakash is able to pass urine easily, yet, he is hesitant to pass stool. What could be the cause behind Aakash's condition?

Bowel movements may seem a relatively simple concept but it may not always be the case, especially for children. When your child passes urine without hesitation but is withholding her bowel movement, you need to investigate the root of the problem.

Withholding bowel movements should not be confused with a behavioural problem. In fact, it is a common toilet training problem, which can be easily dealt with.

Simple ways to help children with bowel movements:

The most common cause for children withholding bowel movements is they had a painful experience passing stool, which has resulted in her fighting the urge to use the toilet. This condition is commonly seen in children between the ages of 2-4 years old, but it can affect babies and school-age children as well. Painful constipation is the culprit in most cases. As parents, you can ensure:

  • Toilet training should be done at the right time and from an early age. The Canadian Paediatric Society says the ideal age to teach your child toilet training is anywhere between 18 months and 4 years.
  • Encourage healthy eating habits in your child. Include more of fibre and fluid in his diet. This will make the stool pass more easily as the fibre will create the bulk and encourage evacuation regularly.
  • You should ensure that children do not develop a fear of passing stools. They should not feel it is a difficult task and have reservations about the same.
  • A routine should be created and encouraged so that the child automatically takes control of his toilet habits.

Is withholding bowel movements a medical problem?

For many parents, toilet training is one of the most difficult tasks related to child rearing. And if your child starts to resist the act of passing stool, it might be a problem.

Do not worry if your child is withholding her bowel movements for it is not a sign of some medical problem. If your child is suffering from constipation and she continues to withhold her stool, she may start feeling even more pain.

Symptoms to look out for:

Although there are a number of indicators, you must watch out for these symptoms:

  • Your child will be irritable and get annoyed at the simplest of things.
  • She will hesitate to go to the toilet frequently and the uneasiness will show on her face.
  • There may be tearing or laceration in cases where the stool is hard.
  • The colour of the stool is often dark and may emit a foul smell.

When to see the doctor?

Even after you have tried methods like including more fibre and fruits in the diet, establishing a routine where the child tries to pass stools at a particular time each day without any results, you must visit the doctor. MayoClinic says the doctor will assess your child for abdominal problems.

Note: Usually, in most cases, the family history and physical examination reveal no underlying medical complications.

Treatment options:

There are certain medicines, which can be used to make the stool pass but this is in extreme cases. Psychologically enabling the child to go to the bathroom by not making it a big deal is important. One must not allow the child to develop a fear about going to the bathroom.

How can parents help a child overcome this habit?

You can do many things to help your child overcome the habit of withholding bowel movement. Regular timings to go to the toilet, increased water intake, a change in diet, potty training and finally a change in behaviour or attitude towards passing stool are some ways to help your child.

With inputs from Dr K. Ramalingam, Director and HOD Paediatriacs, Fortis Hospital, Noida.

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