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Your doctor will ask you questions and examine your child to make sure your child has constipation and to find out what might be causing it.

Your doctor might ask these questions to find out if your child has constipation and how bad it is.^{1 2 3}

• How often does your child usually pass a stool? Has this changed recently?
• What do the stools look like? Are they big or small, hard or soft, formed or loose? What color are they?
• How hard is it for your child to pass a stool? Does your child strain? And how long does it usually take?
• Does your child say it hurts? Do they get upset?
• Does your child put off going to the bathroom?
• Does your child get a stomach ache in between bowel movements? Does it ease up after your child has gone to the bathroom?
• When did the constipation begin?
• Is there any blood on the toilet paper or in your child's stools?
• Does your child always have symptoms, or do they come and go?
• Is your child less hungry than usual?
• Is your child losing weight? Do they have a fever or vomiting?
• If your child is toilet trained, does your child ever leak very soft or liquid stools into his or her underwear?

Your doctor will also try to work out what's causing your child's constipation. They may ask these questions.^{1 3}

• Do other members of your family have constipation? (It can run in families.)
• What's your child's diet like? (Not getting enough water and fiber may cause constipation.)
• Has your child's daily routine changed? For example, have they started a new school or been on vacation? (Changes like this can trigger the problem.)
• Is your child taking any medications, herbal remedies or vitamins?
• What's your child's behavior like? (Holding in stools may be a way to get attention.)

Your doctor may also ask you questions that you find upsetting, such as whether your child might have been abused. This is just to check all possible causes of your child's problem. Try to answer as best you can and not worry about it.

To get even more information, your doctor may ask you to write down what your child eats and how often they pass a stool.

Your doctor may look at your child's bottom to see if it's red or cracked and to check for signs of leaking stool.^{3 4 5}

Your doctor may also put a finger inside your child's anus to check:^{3 4 5}

• If the muscles that let out stools are working properly
• If your child's rectum feels normal inside
• If there's a little or a lot of stool in your child's bowel, and how soft or hard it is.

After talking to you and examining your child, there's a good chance your doctor will be able to tell if your child has constipation and what's causing it. Your child probably won't need any tests.

But your doctor may suggest tests if:²

• They aren't sure your child has constipation
• Your child has serious symptoms (fever, vomiting or weight loss)
• They think a medical condition could be causing your child's constipation.

To learn more, see Tests for constipation in children.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.