How would my GP diagnose and treat it?

Your GP may want to physically examine your child to see if they have faecal impaction. This normally just involves feeling your child's tummy.

Sometimes an X-ray is needed to see how much stool is in your child's bowel and to see if their bowel is enlarged as a result.

If your child has faecal impaction, the first stepis to prescribe laxatives to rid their bowel of the hard, retained stools and to prevent further constipation. Your child will also need to follow a balanced diet and be encouraged to pass stools regularly.

These treatments are described in more detail below.

Medication

Your GP may prescribe an osmotic laxative such as macrogol, which is a sachet of powder you dissolve in water for your child to drink.

This increases the amount of fluid in your child's bowel to soften their impacted stools and stimulate their body to push them out.

Your doctor or nurse will explain how many sachets your child needs to take each day and how much water to add to the powder. Once the powder has been mixed with the water, you may add fruit juice or squash to improve the taste.

To start with, your child will be on a higher dose to clear their bowel (disimpaction), then a reducing dose to maintain regular emptying of the bowel. Your doctor will tell you when to stop the medication, but this will be after the dosage has been gradually reduced.

If you stop the laxatives abruptly or before your doctor recommends, the bowel may not have recovered to its usual size and function, and your child may become constipated again.

Some children may need to continue taking laxatives for several years, and a few children for longer, to completely cure their constipation.

The treatment to get rid of impacted stools may initially increase your child's soiling and tummy pain, but it's important to follow the course your doctor has prescribed.

There's no evidence to support the commonly held belief that using laxatives produces a "lazy bowel".

They should also drink plenty of fluids.

Read about 5 A DAY and your family .

Children with chronic (long-term) constipation normally don't have anything physically wrong with them, but it can take time to correct the problem, so be patient.

Healthy toilet habits

Try to minimise stress or conflict associated with using the toilet.

Establish a regular routine where, for example, they sit on the toilet for 5 to 10 minutes after breakfast and again after dinner every day.

Be positive and encouraging about this routine. Also, encourage your child to go to the toilet as soon as they have an urge to go.

It might help to make a diary of your child's bowel movements linked to a reward system.