Constipation
It is a common problem among children and adolescents. A child is constipated if he/she is passing dry and hard stool and has infrequent bowel movement (less than 3 times in a week).

Symptoms
Defecation, which is the act of passing stool, can be painful and sometimes maybe associated with streaks of blood on the surface of the stool. Some children may present with abdominal pain and nausea. If the constipation is very severe, there may be some clear brown discharge from the anal opening staining the underpants.

Causes
Constipation is usually a temporary problem and most of the time it is not serious. Early toilet training can lead to constipation because the child is forced to sit on the toilet seat and as an act of rebellion he/she may withhold the stool. Older kids, do not like interruption in their playtime or activity so they withhold their stools and if they already have an existing constipation, the thought of the pain makes them withhold their stool even more. It is a vicious cycle. Diet is the biggest factor that contributes to the problem. A low fiber diet and decreased fluid consumption leads to constipation.

Management
Dietary modification is essential for your child. Increase their water and fluid intake. Also, you can give freshly squeezed orange juice as it is rich in fiber. In terms of diet, give them foods that are high in fiber, vegetables which are rich in the fiber are like beans, ladies finger and carrot. Some of the fruits which add to the bulk of the stool and make it easy for passage are papaya, mangoes and bananas. Ensure that your child gets sufficient physical activity. Get them into the habit of timing their bowel movement regularly.

When is it a cause for concern?
If the problem exists for more than 2 weeks, you must definitely have your child see a doctor.

What will your doctor do?
Your doctor will prescribe some stool softener, some laxative and some fiber supplements and advice on all the lifestyle modifications. If the constipation has been a long standing and the child has suffered from cuts, then they can be pre-disposed to what is known as anal skin tags. Your doctor may prescribe some pain relieving ointment to give the child some relief.

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