Constipation is a common concern in children, affecting up to 30% of kids at some point in their lives. While occasional constipation is normal, chronic or severe constipation can interfere with a child’s comfort, growth, and quality of life. Often misunderstood and undertreated, constipation in children can have a variety of causes—and in some cases, pelvic floor dysfunction plays a major role.
One promising and often overlooked treatment for pediatric constipation is pelvic floor physical therapy (PFPT). This specialized form of therapy helps children learn how to properly use the muscles that control bowel movements, often leading to significant improvements in symptoms and overall well-being.
What Is Pediatric Constipation?
Pediatric constipation is generally defined as infrequent, hard, or painful bowel movements. The official medical criteria (Rome IV) include:
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Fewer than three bowel movements per week
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Painful or hard stools
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Large-diameter stools that may clog the toilet
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Stool withholding behaviors (e.g., stiffening the body, hiding, or avoiding the toilet)
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Incomplete evacuation or fecal incontinence
Constipation can lead to abdominal pain, bloating, poor appetite, urinary problems, and social/emotional distress. In chronic cases, it can cause a cycle of stool withholding, which worsens the problem over time.
Common Causes of Constipation in Children
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Dietary Factors: Low fiber intake, inadequate hydration
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Behavioral Factors: Withholding due to pain, embarrassment, or fear of public bathrooms
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Medical Conditions: Hypothyroidism, food intolerances, neurological disorders
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Pelvic Floor Dysfunction: Difficulty coordinating the muscles involved in defecation
This last cause—pelvic floor dysfunction—is where physical therapy can make a significant impact.
What Is Pediatric Pelvic Floor Physical Therapy?
Pelvic floor physical therapy for children involves non-invasive, child-friendly techniques designed to teach kids how to relax and coordinate the muscles of the pelvic floor. These muscles control the bladder and bowels, and dysfunction in this area can lead to incomplete emptying, withholding, and chronic constipation.
Goals of pediatric PFPT include:
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Teaching age-appropriate anatomy and toileting education
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Improving pelvic floor muscle coordination through biofeedback and exercises
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Reducing withholding behaviors
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Supporting proper posture and breathing during toileting
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Encouraging a healthy toilet routine
Evidence and Outcomes
Research and clinical experience show that pediatric pelvic floor therapy can be highly effective for children with constipation—especially when standard treatments (such as diet changes or laxatives) are not enough.
In studies, children undergoing PFPT often report:
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Fewer episodes of constipation
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Less pain during bowel movements
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Fewer accidents or episodes of fecal incontinence
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Improved quality of life and confidence in toileting
What Parents Should Know
If your child has chronic constipation that hasn’t responded to diet changes or medications, it may be time to look deeper. A referral to a pediatric pelvic floor physical therapist can offer a safe, empowering, and non-invasive solution that addresses the root of the problem—not just the symptoms.
Signs your child might benefit from PFPT:
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Straining during bowel movements
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Withholding behaviors
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Fear or avoidance of the toilet
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Frequent accidents despite being toilet-trained
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History of chronic constipation
Always consult with your pediatrician first. If pelvic floor dysfunction is suspected, a pelvic floor physical therapist trained in pediatrics can perform a full evaluation and develop a customized treatment plan.
Final Thoughts
Constipation doesn’t have to be a chronic struggle for your child. Pediatric pelvic floor physical therapy is a gentle, effective, and empowering approach to helping kids overcome constipation and gain confidence in their bodies. When combined with healthy toileting habits, hydration, and support, PFPT can pave the way for lasting relief—and a happier, healthier child.
Looking to optimize your child’s being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected].
