James knew he had to go. But when he got to the boys' bathroom at school, he sat down on the toilet and nothing happened. He waited a couple of minutes and . . . still nothing. He tried pushing but it kind of hurt. After a while a little poop came out, but it was small and hard, sort of like marbles.

James flushed, zipped up, and washed his hands. He didn't feel much better. Why? He was a little constipated.

What Is Constipation?

Constipation (say: con-stuh-pay-shun) is not having a bowel movement (pooping) as often as you usually do or having a tough time going because the poop is hard and dry. Normal poop is sort of soft and easy to pass, so it shouldn't be too hard to have a bowel movement.

When you poop, what ends up in the toilet is the last step of digestion (say: dye-jes-chun), a process that started way back with the grilled cheese sandwich you had for lunch. After you chew and swallow food, it heads to your stomach. From there it's on to the small intestine (say: in-tes-tin), then the large intestine (or bowels), and finally out of the body through the rectum and anus.

All these parts make up your digestive system. As food moves through this system, your body soaks up water and nutrients it needs from the food. What's left over comes out as poop. Flush it and away it goes!

You probably don't think about this when you go to the bathroom. In fact, you may not think about what you do in the bathroom much at all. But when you're not going like you normally do, it may be on your mind a lot and you may feel uncomfortable.

Some people think they're constipated if they don't poop every day, but everybody's bathroom habits are different. One kid might go three times a day, and another kid might only go once every 3 days. So the real sign of whether you're constipated is if you're going less than you normally do.

What Are the Symptoms?

Besides not pooping as often as you usually do, you may feel full and have less of an appetite if you're constipated. Your belly may stick out a little, too. When you do go to the bathroom, you may feel like you have to work really hard to get the poop out, and it might hurt a little to go.

If your poop is hard and dry, pushing it out may cause tiny tears in the skin of your anus. If this happens, you might see a bit of blood on the toilet paper when you wipe. After you're done, you may have only gone a little and feel like you still have to go.

Sometimes when a kid's really constipated, some watery poop like diarrhea might leak out around the hard poop that's still inside. This can cause a messy accident, even for kids who stopped having accidents a long time ago.

If you think you're constipated, or if you see blood on the toilet paper after you wipe, tell your parents. It's probably no big deal, but it's a good idea to let them know what's going on.

Why Do Kids Get Constipated?

Constipation is pretty common and different things can cause it. Reasons why kids get constipated include:

• Unhealthy diet. If you fill your diet with fatty, sugary, or starchy foods and don't eat enough fiber, your bowels may slow down. Fiber — found in fruits, vegetables, and whole grains — can keep your poop from getting hard and dry. So reach for an apple!
• Not enough exercise. Moving around helps food move through your digestive system. If you don't get enough active playtime — like running around outside — you could get constipated.
• Not enough fluid. Drinking water and other liquids keeps poop soft as it moves through your intestines. When you don't drink enough, the poop can get hard and dry and you might get stopped up.
• Not going to the bathroom when you need to. Sometimes kids don't go to the bathroom when they have to. Maybe they don't want to use the bathroom at school or maybe they just don't want to stop what they're doing right then. But if you make a habit of ignoring your body's signals that it's time to go, that might make it harder to go later on.
• Stress. Kids might get constipated when they're anxious about school or something at home. This can happen during scary events, like starting at a new school, or even if you're just worried about a lot of homework and tests coming up. Being away from home for more than a few days may make you feel a little stressed, too. If you think stress is plugging things up for you, talk to an adult you trust about it.
• Irritable bowel syndrome. Some kids have a condition called irritable bowel syndrome (IBS). It can act up when they're stressed or when they run into certain triggers, like fatty or spicy foods. A kid who has IBS may have constipation sometimes and diarrhea sometimes, as well as belly pain and gas.

How Is It Treated?

If you're constipated you probably won't need any special treatment. Chances are you'll soon start going regularly again on your own. If your doctor decides you should come in for a visit, he or she might suggest some medicine or a change in diet to get you going. But don't take any medicine for your constipation unless your doctor recommends it.

Other than some medicine, the doctor might order an X-ray or other types of tests that check out your digestive system. But usually constipation is just constipation. You eventually poop and feel better.

What Can I Do to Help Myself?

You can follow these steps when you're constipated and even when you're not!

• Drink plenty of water. This can keep your poop from getting too hard and dry.
• Eat more fiber. Fruit, vegetables, and whole grains, such as oatmeal and popcorn, all add fiber to your diet. And fiber can keep things moving.
• Ask your parents to use olive oil and other healthy oils in their cooking. This can help make you pass poop more easily.
• Exercise. Throw a ball with your friends, ride your bike, or shoot a few hoops. Activity helps you go to the bathroom regularly. In other words, if you get moving, your bowels will, too!

Reviewed by: J. Fernando del Rosario, MD
Date reviewed: October 2011