Oliva-Hemker says that the problem is exacerbated by the notion that constipation usually goes away on its own, children will outgrow it or that a change in diet alone is enough to restore normal bowel movement.
"Severe constipation needs to be treated early and aggressively," she says. "And no amount of fiber or prune juice will help a child with serious chronic constipation."
Lisa L. Seaman, pediatric nurse practitioner in the Pediatric Gastroenterology and Nutrition program at Johns Hopkins, says the majority of the patients are school age children and toddlers.
"For the toddler population, we try to eliminate the fear of defecation from painful defecation that they experience from constipation," Seaman says. "School age children are more prone to constipation when they are exposed to a bathroom that is less private than the one they have utilized at home. Any child with fear of defecation, pain with defecation, or embarrassment will expose them to be at a higher risk for constipation, at any age."
Seaman says much of the increase in the problem is seen in children who are obese. "Our society's higher fat and carbohydrate diet only exacerbates constipation."