Constipation is a common problem in people with Down syndrome as well as the general population. Studies show that chronic constipation affects between 2 and 27% of the general population. It is thought to be more common in people with Down syndrome due to lower muscle tone (making bowel movements more difficult to pass), other medical conditions that can cause constipation such as hypothyroidism and celiac disease (both of which are more common in people with Down syndrome), inactive lifestyles, diets low in fiber, medication side effects, and lack of hydration.
Constipation is when a person has infrequent bowel movements, which is usually defined as having fewer than three bowel movements per week. It is characterized by hard, lumpy, difficult to pass stools. These can sometimes cause bleeding with passage. Other symptoms of constipation include bloating and abdominal discomfort, pain with pooping, straining with pooping, a feeling of incomplete emptying (tenesmus), and stool incontinence (or accidents). Constipation can also cause urine incontinence and is a risk factor for urinary tract infections.
Some people with Down syndrome have difficulty communicating symptoms related to constipation and sometimes a behavior change may be the only symptom readily identified. Additionally, constipation can be missed at times because a person will be having bowel movements regularly that are loose and easy to pass but these softer stools may be moving past a hard stool lodged in the rectum that hasn’t passed.
If you are concerned that a person may be experiencing constipation, there are some things you can try at home to improve these symptoms.
Eat more fiber such as fruits, vegetables, and whole grains.
Drink more fluids. Water is ideal but non-caloric flavored water and diluted juices are also options.
Increase physical activity.
If these steps do not improve the symptoms, we recommend consulting with a health care provider. The provider may do one or both of the following:
Suggest taking fiber supplements, stool softeners, and/or laxatives. These may include Metamucil, Benefiber, Colace, Miralax, or Dulcolas.
Order an abdominal x-ray or blood tests to evaluate whether hypothyroidism, celiac disease, Hirschsprung's disease, or other conditions are contributing to the constipation.
Original article written by Samantha Ghanayem-Bouikidis, MD in September 2017. Updated by Brian Chicoine, MD in August 2022.
"Gastrointestinal Tract and Down Syndrome." National Down Syndrome Society. N.p., n.d. Web. 22 June 2017.
"Children with Down Syndrome and Gastrointestinal Issues." Down Syndrome | NACD | Health & Wellness | Gastrointestinal Issues. N.p., n.d. Web. 22 June 2017.
Sanchez, Maria Ines Pinto, and Premysl Bercik. "Epidemiology and Burden of Chronic Constipation." Canadian Journal of Gastroenterology. Pulsus Group Inc, Oct. 2011. Web. 22 June 2017.