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Child terrified to pass stools, torn skin due to hard stools. Changed diet and tried enema but no improvement

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my 2 year old daughter is terrified to go to the bathroom (#2). she is holding it for up to 5 or 6 days! It comes out finally, but so huge and hard that she screams and has actually torn skin. i have told my pediatrician but have not found a solution. we have changed her diet, tried enemas, suppositories, miralax, fiber gummies, etc. This has been a problem for about 8 months now.
Posted Sun, 9 Sep 2012 in Child Health
Answered by Dr. Taher Kagalwala 51 minutes later

Thank you for using this website.

After reading your question, I have come to the following conclusions:

This is obviously a problem that is perpetuating itself through the pain->more scared-> more hard stools-> more pain cycle. If you will try and see this in the proper perspective, the pediatrician is acting on measures to soften her stools, but - from what you have written - doing nothing about the pain.

Hence, this is my suggestion: first, concentrate on reducing the pain. Use a local anesthetic gel (usually, we get lignocaine gels - I don't know the brand names ... you can check in NJ).Either 2% or 5% gel can be applied about 10-15 minutes before she goes to the potty.

You can use stool softener like lactulose sodium instead of fibre and miralax etc. If you use an enema, you should use this daily till the colon is completely emptied of all stools

Finally, you need to speak to the pediatrician about whether it can be anything more serious like an obstruction of the rectum or something. Ask him if he is satisfied that the child does not have Hirschsprung's disease.

Please revert to me with more questions, as I am sure you will have more.

I will be pleased to address these questions.

With best wishes,

Dr. Taher
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