Constipation in Children — Medicaid (QUEST) Accepted
Constipation is extremely common in children and, understandably, a frequent source of worry and even painful standoffs at the toilet. The reassuring truth is that most childhood constipation is not caused by anything dangerous, and it responds well to a steady, patient plan.
What constipation looks like in children
Constipation means hard, painful, or infrequent stools. In children it often becomes a cycle: one hard, painful poop leads a child to hold the next one, which makes the stool harder still. Signs include going less often than usual, large or hard stools, pain or straining, belly aches, and sometimes soiling accidents that parents mistake for diarrhea.
How it is understood
Most childhood constipation is what clinicians call functional — meaning there is no underlying disease, and the joint guideline from the North American and European pediatric gastroenterology societies (NASPGHAN/ESPGHAN) frames it this way. That guideline emphasizes starting with education and reassurance, normal fiber and fluid intake, and normal activity.
How we approach it at Ohana Care Clinic
Following the NASPGHAN/ESPGHAN guideline, treatment often pairs those everyday habits with a stool-softening medicine — polyethylene glycol (PEG) is the most commonly prescribed and well-studied option for both clearing a backup and maintenance. The goal is comfortable, regular stools so the holding cycle can end, which can take patience over weeks. We approach it with mālama and without shame — this is a mechanical problem, not a behavior problem, and children do best when the pressure comes off. We also gently watch the emotional side, since toileting stress and anxiety can feed the cycle.
Getting care by telehealth
Most of our care at Ohana Care Clinic happens by secure video across Hawaiʻi. A new primary-care or pediatric patient is seen in person for the first visit at our Hilo clinic; after that, many follow-ups and quick questions work well by video. When your keiki is sick, a video visit can often tell us whether they need to be seen in person, saving you a drive when it isn’t needed.
When to get help now
Call 911 or go to the nearest emergency room if your child is struggling to breathe, turning blue around the lips, unresponsive, severely dehydrated, or you believe this is a life-threatening emergency. When in doubt, call us at (808) 867-8002 or use our symptom checker for after-hours guidance on whether your child needs to be seen.
Medically reviewed by Donna Leonard, MSN, APRN, FNP-C, pediatric nurse practitioner, and George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP, President & Owner of Ohana Care Clinic.
Date published: July 2, 2026 · Last reviewed: July 2026 · Citations verified: July 2026
This article is general health education from Ohana Care Clinic, reviewed by Donna Leonard, MSN, APRN, FNP-C, and George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP. It is not a substitute for a personal evaluation by a qualified clinician who knows your child’s situation, and reading it does not create a provider–patient relationship. If you think your child may have a medical condition, reach out to us or another licensed provider. In an emergency, call 911.
References
Tabbers, M. M., DiLorenzo, C., Berger, M. Y., et al. (2014). Evaluation and treatment of functional constipation in infants and children: Evidence-based recommendations from ESPGHAN and NASPGHAN. Journal of Pediatric Gastroenterology and Nutrition, 58(2), 258–274. https://doi.org/10.1097/MPG.0000000000000266
