Let us divide this into 3 parts
A. The childs problem B. test report intepretation C. diet management of constipation
A. Child having constipation and hardened stools. Imagine a wet cloth. When you want to dry, you squeeze the cloth. water gets separated. Similarly the part inside the anal opening is called rectum
, and when the boy strains, he squeezes the muscles around the rectum. In normal course of events, the motion should be pushed out. If it does not the water in the stool gets drained and the stool becomes dry. The dry stool will irritate the inner skin called mucosa causing some tear. This is called a fissure. This tear may be small and may not progress to a fissure, yet, it will cause pain and the boy will squeeze, but will not apply sufficient pressure to expel the motion. This leads to cycle of pain causing dry stools and in turn the dry stool causing more pain.
B. The tests are normal. Occult blood positive can come even if you given 25 grams of mutton or beef or cooked goat liver
C. To me your child needs
i. Diet manipulation. Stop milk because it contains lot of phosphates. Particularly cows milk. Avoid dry food like biscuits chips,
ii. To increase fluids: water butter milk. Green leafy vegetables, fibre rich food: legumes. If he wants snacks, give him, popcorn.
iii. Avoid television and give him more activity
Apple may not be appropriate, because, the most useful aspect is the seeds and fibrous portion around the seeds. This way we usually remove and hence if your child has improved means it may not be due to apple. Chiku and banana are the other useful fruits
Hope you could have some insight to his problem