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Date of last update: 9/9/2017.

Forum Name: Pediatric Topics


 MANAZER - Wed Feb 09, 2005 7:22 am

Dear Doctor,

I am writing this for my son. He is 4 years old. His problem is of irregular bowel habits. Recently (almost one month now) his bowel movements happens once in 3-4 days. He looks very worried to go to toilet. Though we have included lot of fiber rich food, like fruits, leafy vegetables, it remain as it is. When the movements occurs, the stool come out is very hard and painful which we can notice in his face. We have consulted a doctor and has been prescribed Duphalac Lactulose Solution 5 ml every day and Skilax 15 Ml 5 drops in the night. This medicine was given for almost 2 weeks but no success. Please advise us what steps we have to take to make his bowel movements as a regular and routine. When we compel him to go to toilet, he looks very worried and start crying. Please advise through this valuable site.

Best regards,

 Dr. Heba Ismail - Fri Feb 11, 2005 11:54 am

Dear Manazer,
It is always wise to seek consultation when a child fails to respond to routine therapy or when management is otherwise complex.
Now, I'm sure your doctor has excluded the possibility of anal fissures, but may be he'd like to recheck, since your child obviously suffers pain on defecating. Also, with such a recent onset, and with the hard stools, it is very likely.
Elimination of any pain associated with the passage of bowel movements is extremely important and using very large doses of laxatives to produce very soft stools may be necessary.
If the child has anal fissures, using Xylocaine ointment or hydrocortisone suppositories for a short period of time to provide symptomatic relief may be appropriate.
It is also important to establish regular and routine toilet times, once or twice daily for 5-10 minutes, preferably after feeding.
As regards diet, continue to administer lots of fluids, especially fruit juice, and carbohydrates. A balanced diet that includes whole grains, fruits, vegetables, and lots of fluid is always recommended.
You may also consider removing cow's milk protein from your child's diet.

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