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4 yr old poops for long time, dark and pasty stool. Gave miralax, pedialax. Should be concerned ?

my 4 yr old has had problems pooping for a long time. she crosses her legs, will only poop in a diaper and now her poop is very pasty and very dark in color. when she was at the doctors for her 4 yr check up in sept the doctor felt her bellly and said she was a little backed up. I give her miralax on a daily basis and occasionally give her pedialax. should I be concerned with the dark pasty stool?
Asked On : Sat, 3 Nov 2012
Answers:  1 Views:  279
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Pediatrician, Neonatology 's  Response
Dark pasty stool in child may be normal or abnormal depending on following conditions.

If the baby is taking oral iron fortified formula, or iron containing medicines (used for anaemia), dark green leafy vegetables (spinach, legumes, broccoli etc). Try to find out any recent change in the child's diet coinciding with dark stool.

Abnormal dark tarry / pasty stool may be due to upper gastrointestinal(GI) bleeding. Though the incidence is less common than normal dark stool. A severe gastrointestinal infection, allergic reaction, side effect of drug etc- may cause hemorrhage in GI tract causing dark stool.

Another possibility could be due to impaction of stool for long time. When stool is retained for long time, moisture is absorbed from it. It get harder and the colour changes to dark. The yellow pigment present in stool is due to Stercobilinogen (secreted in bile), which turns into Stercobilin - causing dark colour. When you give laxative, the retained stool becomes soft and comes out in darker pasty form.

It would be wise to collect the stool and examine it in pathology laboratory (for routine examination and microscopy). Any abnormality will get detected in report.

WARNING : Do not give laxative to your child unless advised by your doctor. If your child has constipation, ensure that she drinks sufficient water. Then go for dietary managements (like adding whole wheat, dietary fibers, vegetables ; removing constipating foods like banana, milk, carrot, low fibre foods) & bowel habit (train your child for regular bowel practice, encourage to spend longer time in toilet if she is holding bowel). Laxative are not for daily use. If she has constipation for long time - consult your doctor.

I have discussed the possible causes of such dark pasty stool. Preserve the stool and show it to your pediatrician. Clinical examination of your child supported with pathological testS will be the best way to find out the cause.

Hope I could make it clear. Post if you have further queries.
Answered: Sun, 4 Nov 2012
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