4yr old with painful bm & blood tinge WHAT COULD THIS BE?

[CaraT]

My 4 yr old son has had large painful bowl movements along with blood tinge on the paper for almost a year now. I have visited the primary Dr a few times and they have said to cut out dairy and give prune juice along with taking a prescription stool softener. I have followed their instructions and still my son is having such painful bowel movements that he holds the seat and tends to hold his breath because of how uncomfortable it is to go. He tells me every time he goes it hurts when it comes out. Most of the time when I wipe him there is blood on the paper. Which I was told is just tear in the tissue from straining. Like I said I have followed the Dr instructions and still no difference. What could this be??

[Shelly Hoppe EMTP]

Greetings CaraT:

Sometimes small children will hold their BM due to a painful bowel movement. One painful bowel movement can trigger a cycle of sorts. The first painful bowel movement can lead to behavior of trying to "hold it" in order to avoid the pain. This leads to larger stool which leads to another painful BM. Watch his behavior and if he seems to be attempting to avoid going potty this could be the problem. As always, be sure to keep your son's physician aware of any new or worsening symptoms.

[CaraT]

Thank you very much I really appreciate it. One thing though...my son doesn't and hasn't held his BM, sometimes he goes more then once a day. Any ideas of what else this could be?
Thanks again
Cara