A compassionate guide to understanding and supporting your child
Written by Anna Katherine Black, PhD
Licensed Clinical Psychologist
GI Psychology
Constipation is one of the most common gastrointestinal concerns in children, affecting up to 30% of kids worldwide (Rome Foundation, 2021). While occasional constipation is normal, chronic constipation can interfere with school, play, and emotional well-being. Many parents worry when their child struggles with painful bowel movements, stool withholding, or anxiety around the bathroom. The good news: with the right strategies—medical, behavioral, and emotional—children can find relief and confidence again.
What is Constipation in Children?
Constipation is when a child has fewer than three bowel movements per week, or when stools are hard, painful, or difficult to pass (American College of Gastroenterology, 2023).
A key factor in children is withholding—when kids intentionally avoid going to the bathroom because of pain, fear, or inconvenience. Over time, withholding can make constipation worse, creating a cycle of discomfort and anxiety.
Why Constipation Happens
Constipation in kids is usually functional—meaning it’s not caused by a serious disease, but by how the gut and brain interact. Contributing factors can include:
- Dietary patterns: low fiber, not enough fluids
- Withholding behaviors: avoiding the toilet at school, fear of pain
- Stress and emotional factors: changes at home, anxiety, or transitions
- Medical conditions: occasionally linked to IBD, celiac disease, or neurological concerns (Crohn’s & Colitis Foundation, 2023).
The Gut-Brain Connection and Constipation
The gut-brain connection plays a big role in how kids experience constipation. Stress and worry can worsen symptoms, and painful bathroom experiences can increase fear, leading to more withholding.
Evidence-based therapies—including Cognitive Behavioral Therapy for GI and gut-directed clinical hypnosis—help children reduce fear, build confidence, and re-train the brain-gut pathway to support more regular bowel movements (APA, 2020; Navidi, 2025).
Tips for Parents: Helping Your Child with Constipation
1. Create a bathroom routine
Encourage your child to sit on the toilet for 5–10 minutes after meals. This takes advantage of the body’s natural “gastrocolic reflex,” when the gut is most active.
2. Normalize the experience
Let your child know constipation is common and not their fault. Shame-free conversations reduce anxiety.
3. Support hydration and fiber
Offer fruits, vegetables, and whole grains, and keep water easily available. Small changes add up.
4. Use rewards for effort, not results
Praise your child for trying, sitting on the toilet, or talking about their symptoms—not just for “going.” This reduces pressure and supports behavioral change.
5. Seek behavioral therapy when needed
If constipation is persistent or linked to anxiety, a licensed clinician trained in pediatric GI psychology can help. RCTs show that CBT and gut-directed hypnosis improve symptom control and reduce stress in children with functional GI disorders (Szigethy, 2015; Keefer & Palsson, 2008).
When to Call the Doctor
See your child’s pediatrician or gastroenterologist if constipation is:
- Lasting more than 2 weeks
- Causing severe abdominal pain or vomiting
- Leading to weight loss or poor growth
- Associated with blood in the stool
Early evaluation ensures medical conditions are not missed, and treatment can begin quickly.
Takeaway: Your Child is Not Alone
Constipation in kids is common, treatable, and often greatly improved with a mix of medical care, parent support, and behavioral strategies. You don’t have to navigate this alone—help is available.
- Printable resources and educational support
- Schedule a consultation with our team to see how GI Psychology can support your child and family
- Reach out directly: admin@gipsychology.com
References
American College of Gastroenterology. (2023). Pediatric Constipation. https://gi.org
American Psychological Association. (2020). Evidence-based practice in psychology. https://apa.org
Crohn’s & Colitis Foundation. (2023). Constipation in children with IBD. https://www.crohnscolitisfoundation.org
Keefer, L., & Palsson, O. (2008). A randomized trial of hypnosis and CBT for IBS in children. Journal of Pediatric Gastroenterology & Nutrition, 47(1), 45–52.
Rome Foundation. (2021). Childhood functional GI disorders. https://theromefoundation.org
Szigethy, E. (2015). Cognitive-behavioral therapy for children with functional GI disorders: A randomized controlled trial. Clinical Gastroenterology and Hepatology, 13(12), 2044–2051.
Navidi, A. (2025). Psychological treatments for IBD [Conference presentation]. Crohn’s & Colitis Foundation, Washington, DC.