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A study in the International Journal of Nursing Studies explored why children receiving treatment for functional constipation put off using the toilet. Interviews with 20 children aged 6 to 14 identified pain, distraction, embarrassment and worry about adults’ reactions among the reasons; the small study does not establish how common each experience is.
Researchers at Linköping University in Sweden found that children receiving treatment for functional constipation may put off going to the toilet for reasons including pain, distraction, embarrassment and fear of getting into trouble. The study, published in the International Journal of Nursing Studies, draws on interviews with 20 children aged 6 to 14 and offers insight into their experiences, rather than measuring how common each reason is among children generally.
The researchers interviewed children receiving treatment for functional constipation, described in the report as difficulty passing stools regularly or comfortably without an identifiable underlying disease. Some children said they delayed toilet visits to continue an enjoyable activity. Others described becoming so absorbed in play that they did not notice, or did not respond to, their body’s signals.
Discomfort was another reported reason. Children described pain, tummy aches, straining and difficulty passing stools. One eight-year-old compared the sensation to needles poking their bottom. These accounts suggest that avoiding the toilet may sometimes reflect an attempt to avoid an unpleasant experience, rather than deliberate defiance.
Children also spoke about the social and emotional effects of constipation. Some feared classmates would notice an accident or smell, and the report says some avoided sports or went home after school instead of spending time with friends. A few children were reluctant to tell parents about accidents because they worried about their reaction. The interviews also covered treatment: children had experience with oral stool-softening medicines and enemas, which some found frightening or uncomfortable even when they recognised that an enema could bring relief.
Pain and Shame Can Shape Toilet Avoidance
The findings matter because they give parents and caregivers a child-centred account of behaviour that adults may otherwise interpret as stubbornness or refusal. Pain can make a child wary of trying again, while anxiety about accidents, classmates or parental anger can make it harder to ask for help. Distraction may also mean a child does not act promptly when they first feel an urge.
The study does not test a specific parenting approach or show that any one response will resolve constipation. It does, however, point to reasons to ask what is making toilet visits difficult and to respond without blame when accidents happen. The source report advises parents who are concerned about constipation to contact a GP, consistent with its description of NHS advice. Individual care and treatment decisions should be discussed with a health professional.
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What the Children Were Asked
This was a small interview study, not a survey of all children with constipation. Its 20 participants were aged 6 to 14 and were already receiving treatment for functional constipation. Their accounts can help identify experiences and concerns that may be missed when attention is focused only on symptoms, but they cannot establish how often each experience occurs across a wider population.
According to MadeForMums’ report, the children had experience taking oral stool-softening medicines and receiving enemas. Their comments described different responses to treatment: some associated enemas with relief, while others felt frightened, uncomfortable or upset beforehand. The researchers’ emphasis, as relayed by the report, was on listening to children and including them in conversations about care.
“My brain is busy and doesn’t… care that I need to poop and pee and doesn’t tell my body to go to the bathroom and stuff.”
— Jack, aged 9, quoted in MadeForMums’ report
Limits of the Interview Findings
The interviews involved only 20 children already receiving treatment. The supplied report does not give the study’s publication date, detailed methods, or information about whether the participants’ experiences reflect those of children who are not in treatment. It also does not provide figures showing how many of the 20 children cited each reason.
The findings identify experiences reported by these participants; they do not prove that pain, embarrassment or distraction explains toilet avoidance in every child. Nor does the report establish which treatment or parenting response works best. Those questions cannot be answered from the interview findings described here.
When Parents Should Seek Advice
The report says the researchers emphasised hearing children’s concerns and involving them in discussions about treatment. For families, the immediate issue may be to find out whether a child is worried about pain, missing play, using a school toilet, accidents or an adult’s response, rather than assuming the child is simply refusing.
MadeForMums reports that the NHS advises parents who think a child is constipated to seek help from a GP rather than waiting for the problem to resolve on its own. The study provides no announced follow-up trial or further research timetable. Persistent symptoms, treatment choices and concerns about a child’s health should be discussed with a qualified health professional.
Key Questions
What reasons did children give for avoiding the toilet?
In interviews, children described pain or difficulty passing stools, distraction during activities, embarrassment about accidents and worry about how parents or friends might react. The study does not show how prevalent each reason is.
How many children took part in the study?
The researchers interviewed 20 children aged 6 to 14 who were receiving treatment for functional constipation.
Does the study show that children are avoiding the toilet deliberately?
No. Some children reported choosing to delay a toilet visit, while others said they became absorbed in an activity and did not notice or respond to their body’s signals. The interviews also described pain and anxiety.
What should parents do if they think their child is constipated?
The source report says NHS advice is to contact a GP if a parent thinks their child is constipated. A health professional can discuss the child’s symptoms and care.
Source: madeformums.com
