What is Constipation and Why Does It Occur?

1. What is Functional Constipation?

Functional constipation is a type of constipation that occurs without any structural, anatomical, or biochemical abnormality. This means there is no organic disease in the child's intestines or digestive system, yet their bowel movement pattern becomes disrupted. It typically occurs in children older than 1 year and most commonly begins during the preschool period. This type of constipation can lead to other problems in children, such as fecal incontinence (encopresis), abdominal pain, loss of appetite, and restlessness.

The most common cause of functional constipation is the child's habit of withholding stool. This situation usually begins during toilet training. The child holds their stool because they do not want to use the toilet. Over time, when the intestines hold the stool for an extended period, the stool hardens and defecation becomes painful. This leads the child to withhold their stool again, creating a vicious cycle. When there is no defecation for several days, the child does not want to poop because this process has become painful for them.

The diagnosis of functional constipation is generally made through a detailed evaluation of defecation habits. Scientific criteria called the Rome IV criteria guide us in making the diagnosis. For example, if a child has symptoms such as defecating two or fewer times per week in the past month, fecal incontinence, or passing hard stools, functional constipation is suspected. These criteria vary according to the child's age, but the constipation must have been ongoing for at least one month.

Functional constipation is a very common and treatable condition. It is very important for parents to approach this process patiently and adopt a supportive attitude without being stubborn with the child. The treatment process can sometimes take several months; therefore, regular follow-up and lifestyle changes are recommended for permanent results.