During Toilet Training, Constipation Occurs Before Stool

ABSTRACT. Background. Previous studies demon-strated that constipation and painful defecation are asso-ciated with stool toileting refusal (STR), but whether they are the result of STR or occur before this behavior is not known. Objective. To determine whether constipation and painful defecation occur as a result of STR or occur before STR. Methods. Three hundred eighty children between 17 and 19 months of age participated in a prospective lon-gitudinal study of toilet training. Children were moni-tored with telephone interviews every 2 to 3 months until the completion of daytime toilet training. Information obtained in follow-up interviews included parents ’ re-ports on the presence and frequency of hard bowel move