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Constipation can be very uncomfortable. Your child may that they have a stomach ache or that it hurts when they go to the bathroom.

Here are some signs that your child may be constipated.

• Fewer bowel movements than normal: Your child may not have a bowel movement for several days.
• Pain and straining: Stools that your child holds in for a long time get hard and dry. These are more difficult to pass, and your child may say it hurts. They may get anxious and upset when it's time to go to the bathroom.
• A stomach ache that goes away after passing a stool: Your child may get cramps and feel bloated and queasy because of the build-up of stools in the bowels. These feelings go away after your child passes a stool. But they'll come back if your child's bowels fill up too much again.
• Small, dry and hard stools: The bowels pull water out of stools, so the stools dry out and get hard if they stay in there too long. Some children with constipation pass small amounts of pellet-like stools fairly often. Others won't go for several days or longer because they can't or don't want to. Or they may eventually pass stools that are so big and hard they block the toilet.
• Avoiding the toilet: Your child may try to avoid going to the bathroom. Or they may behave unusually while using the toilet. Children with constipation may stiffen their buttocks and legs and stand on their toes, rocking back and forth.
• Not having any urge to pass a stool: If your child stays constipated, they may not even get the urge to pass a stool. This happens because stool builds up and stretches your child's rectum. A stretched rectum needs more stools in it before your child senses the need to push them out. This keeps the constipation going.
• Feeling a bowel movement isn't finished: If your child's stools are dry and hard to pass, some stay in the bowels after a bowel movement. So your child may feel like they still have to go.
• Sore bottom: The skin around the anus can tear if your child has to strain. It can feel sore, dry out and crack. You might see bright red blood or light red streaks in your child's stools or underwear. Treating your child's constipation should stop this. Once the stools are soft again, the skin on your child's bottom should heal.
• Unpleasant smell: If your child's holding in stools, they might smell bad. This may be because some gas or stool is leaking out into your child's underwear.

If your child has bad constipation, they may also get these symptoms.

• Dribbling urine: Your child may dribble urine into their underwear, they may have to pass urine more often than usual and they may wet the bed. These things happen because the stools backed up in your child's bowels press on the bladder (the sac that holds urine) and the muscles that control peeing. This lets urine leak out more easily. Your child may even get a urinary tract infection because of the dribbling. The good news is that once the constipation eases, these things clear up, too. ¹
• Leaking of liquid or loose stools: Your child may leak watery stools into their underwear. Doctors call this encopresis. It happens when large stools get stuck and block your child's bowel. Liquidy stools above the blockage flow around it and out of your child's anus. Your child may scratch or rub around this area because it's irritated from the watery stools.

If your child has very bad constipation, they may get these symptoms too:

• Fever
• Vomiting
• Weight loss.

These more serious symptoms happen in only a few children with constipation. But if they happen in your child, see your doctor.