Fast facts
- Constipation is when someone has trouble pushing out poo or not pooing regularly.
- Constipation can make pelvic pain worse.
- Pelvic pain can also contribute to constipation.
- Drinking enough water and eating regularly can support healthy bowel movements.
- If your child or young person’s symptoms are not getting better, it’s time to talk to their doctor.
What is constipation?
Constipation is when someone has trouble pushing out poo, or they’re not pooing regularly. Pelvic pain can lead to constipation, but constipation can also make existing pelvic pain worse.
Being constipated increases pressure, irritation, and inflammation in the pelvic area. If your young person is constipated, they might feel bloated, crampy, or spend a long time on the toilet trying to poo.
Muscles can get overprotective and tighten up when pain is present. If the muscles in the pelvic floor – the door that controls pee and poo – tighten, it can be harder to fully relax the bowels and bladder to poo or pee.
If your young person ignores the urge to poo, their poo can get harder, drier, and more uncomfortable to push out. This can lead to an ongoing cycle of discomfort and constipation.
Many things can contribute to your young person’s constipation, such as the:
- Food they eat
- Medicine they take
- Exercise they do
- Way they sit on the toilet.
Poo can give you a good indication of health. It’s good for your young person to get to know their poo and how often they go, so they know what’s normal for their body.
Signs your young person may be constipated include:
- Spending a long time on the toilet
- Complaining that it hurts to do a poo
- Needing to strain to pass a poo
- Having hard poo.
What helps with constipation?
Manage stress and distraction
- Talk to them about their stress levels – stress can cause their metabolism (how their body converts food to energy) to slow down.
- Encourage them to spend time doing things they enjoy. They could also try meditation or grounding exercises.
- Encourage them to use distraction as this can help relax their muscles – they could try watching a TV show or video, reading a book, or listening to music.
Use heat
- Use heat to encourage their bowels to start moving – they could rest a heat pack on their stomach or lower back, or take a warm shower.
Toilet position
Encourage them to change their position while sitting on the toilet. It’s generally best to:
- Rest feet flat on the floor (not dangling) as this helps the pelvic floor muscles to relax
- Have knees slightly higher than the hips; using a foot stool can help
- Lean forward slightly with a straight back (not slumped over)
- Place elbows or hands on knees, if it’s comfortable
- Relax shoulders and stomach.
Timing and habits
- Don’t ignore the urge to poo.
- Bowels are usually most active 15 to 30 minutes after eating.
- Avoid rushing on the toilet, but don’t sit too long either; it’s okay for them to sit for five minutes but discourage them from staying longer than 10 minutes.
- Avoid straining on the toilet; this can worsen their pain or cause their pelvic floor muscles to get even tighter, making it harder to empty their full bowel or bladder. Instead of straining, focus on belly breathing.
Food and drink
Water
- Drinking enough water throughout the day can help soften poo. Your young person can:
- Carry a drink bottle with them
- Drink warm or iced drinks if they prefer; they can also add fruits to their water, or drink herbal tea
- Set regular alarms to remind them to drink
- Use smartphone apps to turn drinking water into a game.
Eat regularly
Help your young person establish routines to combine multiple healthy food and drink habits. This is sometimes called habit stacking. For example, use the toilet when they wake up, then drink a glass of water.
Encourage them to eat regularly. Food is a signal to the body to move the bowel. For most young people, three meals a day with two to three snacks is a good amount of food to fuel their body. Their digestive tract is like a conveyor belt – regular meals keep it moving.
When they skip meals:
- The colon slows down
- Poo sits in the bowel for longer
- More water is absorbed out of the poo, making it harder to push out
- Harder poo causes more straining and tightens the pelvic floor muscles, leading to more pelvic pain.
Fibre
Fibre helps bowels to work well and supports healthy gut bacteria. This helps to reduce inflammation and pain and also supports mental health.
There are two main types:
Soluble fibre
Helps to soften poo and is gentler on bloating. It’s found in:
- Rolled oats, porridge
- Chia seeds
- Ground linseeds (flaxseed)
- Fruit like kiwi fruit, berries, apples, pears, bananas
- Vegetables like eggplant, peas, avocado, sweet potato, carrot, turnip
- Legumes like lentils, chickpeas and beans.
Insoluble fibre
Adds bulk to poo and helps it move through the bowel. It’s found in:
- Fruit, particularly the skin and seeds
- Vegetables, particularly the skin and seeds
- Wholegrain products like pasta, bread, brown rice, quinoa, barley
- Nuts and seeds.
Start by gradually adding more fibre to their diet. Adding too much fibre too quickly, especially if they’re not drinking enough water, can make bloating worse – so go slowly.
Laxatives or stool (poo) softeners
- Laxatives or stool softeners help to soften poo making it easier to pass. You can buy laxatives at pharmacies.
- If you give your young person laxatives or stool softeners, it’s good to remember there’s usually a lag time between taking them and needing to go to the toilet.
- Sometimes it can help to take laxatives or stool softeners consistently, rather than waiting until they have symptoms of constipation.
- There are different types of laxatives – speak to their doctor or a pharmacist about which laxatives might work for them, how much they should take, and how often they should take them.
When to get help
Changes often take time and you might not notice a difference overnight. However, sometimes reducing stress or changing what your young person eats isn’t enough to relieve constipation.
If their symptoms are:
- Making their pelvic pain worse, or
- They struggle with certain textures, food, or eating.
It might help to get some extra support.
Support options
- A regular doctor (GP) can help and can refer you to a dietitian, physiotherapist, or occupational therapist they recommend.
- A dietitian (a specialist in food and nutrition) can help change eating habits and share advice around things like adding more fibre to their diet or suggest a supplement that can help with constipation.
- A pelvic floor physiotherapist can teach your young person exercises to relax their pelvic floor.
- An occupational therapist (OT) can help your young person overcome challenges to complete everyday activities – for example, teaching them techniques to relax their muscles when going to the toilet.
Helpful links