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Child suffering with constipation and on high fiber diet. What should be done?

DOCTOR OF THE MONTH - Jan 2013
Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
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My son has got over a long standing constipation issue since potty training that he had lactulose for he no longer has hard stools. He now seems to not know that he keeps soiling pants up to 3 times a day. Don't know what to do. He is not quite 4 and I have him on a high fibre diet.
Posted Tue, 1 Jan 2013 in Digestion and Bowels
 
 
Answered by Dr. Mayank Bhargava 1 hour later
Hi XXXXXXX,
Welcome to XXXXXXX forum.
Let me know the associated symptoms along with watery shit.
Does he has spasmodic abdominal pain/ excessive flatulence/ vomiting/ fever?
Are you still using lactulose ?
What was the cause of persistent hard stool (constipation)?

There may be possibility of acute gastroenteritis as suggested by watery shit and spoiling of pants.
Excessive lactulose dosage may also cause watery shit.
There may also be possibility of Small intestine bacterial overgrowth (SIBO) and it has a typical history of constipation followed by watery shit.

You should consult with pediatric physician/ gastroenterologist and should go for thorough check up.
SIBO is diagnosed by endoscopy along with duodenal aspiration culture.
You should go for lactose free diet means avoid milk and all milk related products such as cheese, butter, yogurt.
You should maintain proper hydration.
Antibiotics must be used only under expert guidance of your treating doctor.
Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
 
Follow-up: Child suffering with constipation and on high fiber diet. What should be done? 4 hours later
He is currently off lactulose. We think he was withholding his stool as he was going for 5 days without a poo. He is very gassy and complains of tummy ache.
 
 
Answered by Dr. Mayank Bhargava 7 hours later
Hi,
He is most likely suffering from acute bacterial gastroenteritis.
This pathology has typical history of using washroom but without poo.
Presence of abdominal ache and flatulence suggests the diagnosis.
You should consult with pediatric physician/ gastroenterologist and take proper treatment at right time.
Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
 
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