Constipation chronic in teenagers

Overview

Chronic constipation is when a teenager has hard, dry, or infrequent bowel movements (poo) that last for several weeks or longer. It means the bowel movements are difficult to pass and happen less than three times a week.

Yes, chronic constipation is fairly common in teenagers. Many young people experience it at some point, and it can affect both boys and girls.

Teenagers of any age can be affected, but it is more common in those who eat a low-fibre diet, drink too little water, or are less physically active. It can also happen during times of stress or major life changes.

Symptoms

Common symptoms

• Having fewer than three bowel movements in a week
• Stools (poo) that are hard, dry, or lumpy
• Straining or pain when trying to pass stool
• Feeling like you haven't completely emptied your bowels
• Bloating or discomfort in the belly

Symptoms in children

• In younger children, symptoms may include holding in stool (withholding), crossing legs, or hiding to avoid going to the toilet.
• Teenagers may be embarrassed to talk about it, so look for signs like avoiding the toilet or complaining of stomach ache.

Symptoms in older adults

• Older adults with constipation may also have the same symptoms, but they are more likely to have other health conditions or medications that contribute.

Causes

Main causes

• Not eating enough fibre from fruits, vegetables, and whole grains
• Not drinking enough water or other fluids
• Ignoring the urge to go to the toilet (holding it in)
• Lack of physical activity
• Changes in routine, like travelling or starting school
• Some medications (e.g., certain painkillers, antidepressants, or iron supplements)

Risk factors

• A diet low in fibre and high in processed foods
• Not drinking enough fluids
• Being less active or spending long hours sitting
• Stress, anxiety, or depression
• A family history of constipation
• Having an eating disorder

When to see a doctor

See a doctor urgently if:

• If your teenager has severe belly pain that is getting worse
• If they have blood in their stool or vomit
• If they cannot pass any stool at all for more than a day with pain

Book a routine appointment if:

• If constipation lasts for more than three weeks despite trying home remedies
• If it is causing pain, bleeding, or extreme discomfort
• If it is linked to weight loss, fever, or other concerning symptoms

Diagnosis

A doctor will ask about your teenager's symptoms, diet, and daily habits. They may also ask about bowel movements and any medications. The doctor will likely do a gentle physical exam, including pressing on the belly.

Tests that may be done

• Usually no tests are needed. The diagnosis is based on the history and physical exam.
• If needed, the doctor might order a blood test or imaging (like an X-ray) to rule out other causes.
• In rare cases, a test called a colonic transit study may be done to see how quickly stool moves through the bowel.

What to expect at your appointment

The doctor will explain that constipation is manageable. They may suggest changes in diet and lifestyle first, and possibly a short-term plan to soften the stool. If there are concerns, they may refer to a specialist like a gastroenterologist.

Treatment

Treatment focuses on making the bowel movements easier and more regular. This usually starts with changes to diet and lifestyle. If needed, a doctor may recommend a mild laxative for a short time, but always under their guidance.

Self-care at home

• Increase fibre gradually with fruits, vegetables, beans, and whole grains
• Drink plenty of water (aim for 6-8 glasses a day)
• Be physically active every day (e.g., walking, cycling, sports)
• Set a regular time each day to use the toilet, after meals
• Don't ignore the urge to go

Medical treatments

If self-care is not enough, a doctor may suggest a short course of a laxative that is gentle and safe for teenagers. Never use a laxative without medical advice. For severe or persistent cases, a doctor might prescribe medication that helps the bowel muscles work better. Always follow your healthcare provider's instructions.

When is surgery considered?

Surgery is almost never needed for constipation in teenagers. It is only considered if a rare physical problem is found, such as a blockage or a structural issue.

Living with this condition

Living with chronic constipation can be frustrating, but with simple changes it often gets better. Encourage your teenager to stick with a healthy routine and be patient, as improvement can take a few weeks.

Lifestyle tips

• Make a daily bathroom routine, like sitting on the toilet after breakfast
• Add fibre gradually to avoid gas and bloating
• Drink water throughout the day, not just when thirsty
• Get regular exercise most days of the week

Diet and exercise

A diet rich in fibre (like oats, apples, pears, broccoli, and lentils) and plenty of fluids helps soften stool. Regular physical activity, even a 20-minute walk, can stimulate bowel movements. Avoid too much junk food and sugary drinks.

Mental health and emotional wellbeing

Constipation can cause embarrassment or stress, especially for teenagers. It may affect mood or social life. It's important to talk openly and reassure them that it is a common problem that can be treated. If worry or sadness lingers, consider speaking to a school counsellor or doctor.

Prevention

Chronic constipation can often be prevented by eating a high-fibre diet, drinking enough water, staying active, and not ignoring the urge to go to the toilet. Establishing healthy habits in the teenage years can help prevent future problems.

Complications

If left untreated

• Anal fissures (small tears in the skin around the anus, causing pain and bleeding)
• Faecal impaction (hard stool stuck in the rectum that is very difficult to pass)
• Soiling (leaking liquid stool around the hard lump, causing embarrassment)
• Haemorrhoids (swollen veins around the anus)

Long-term outlook

With the right care, chronic constipation in teenagers almost always gets better. The outlook is very good – most teenagers find relief with simple diet and lifestyle changes. Even if it takes a few weeks, there is no reason to lose hope. Your healthcare team is there to help.

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