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Pain in the anus due to constipation, Fiber rich foods and Stool softening medications - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Digestion and Bowels
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3617 Questions
Doctor :   Hi
User :   Hello. my 2 year old daughter is complaining that her anus is hurting, in her broken language. What do you suggest?
User :   what do you think is the problem? Could it be worms?
Doctor :   Ok.
Doctor :   May I ask you a few questions pertaining to her problem ?
User :   sure, please go ahead
Doctor :   May I know if she is suffering from any Diarrhea ?
User :   No Diarrhea.
Doctor :   May I know if she is having nay constipation since last few days ?
Doctor :   sorry *any
User :   Yes she has had constipation over the last couple of weeks. We have been treating her with Dupholac and Cremafin.
Doctor :   Ok.
Doctor :   How is she as of now , did she have at least one normal stool in last 24 hrs ?
User :   Yes she does have normal stool occasionally after medication. She has had normal stool last night.
Doctor :   Ok.
Doctor :   Do you feel that the hurt in the anus could be because of a hard stool or anything else , any blood or anything else in stool ?
User :   No blood in stool. Last night the stool she passed was soft.
Doctor :   That is encouraging.
Doctor :   Does she have nay itching around the anus, suspecting a pin worm or seat worm infestation ?
User :   we are not sure if she has itching. She keeps complaining that her bottom hurts her. She stops complaining after passing stool. But again today since morning she's complaining her bottom hurts her.
Doctor :   I feel it might be due to a constipation and not a worm infestation, though there is nothing wrong in taking an anti-helminthic syrup, I suspect the hurt is due to constipation itself.
Doctor :   Have you been taking stool softener as prescribed by a Pediatrician or should I help you with that ?
User :   We have been taking Dupholac and Cremafin, both prescribed by a Pediatrician. We forgot to mention that she complains of her bottom hurting, hence not sure what to do about that.
User :   She pretty much complains all day long.
User :   She complains for some time then stops, then complains again.
Doctor :   I do understand the problem faced by the kid but without physical examination , it becomes rather difficult but Unlike laxatives, stool softeners used in children are not usually addictive and can be given every day if necessary. A common mistake is for parents to stop stool softeners once a child begins having soft bowel movements, only to have the child soon develop constipation again. Stool softeners are often used for 4-6 months and then slowly decreased to prevent reoccurances.
Doctor :   A stool softener i s totally different from a laxative.
User :   Are Dupholac and Cremafin stool softeners?
Doctor :   As she doesnt have any other major complaint I do not feel there is any other problem, Dupholac is laxative, But Cremaffin is a stool softener.
Doctor :   Malt Soup Extract: or Maltsupex, it has an unpleasant odor, but is easily mixed with formula for younger children.
Doctor :   It is the best stool softener.
User :   Doctor what can you prescribe for anti-worm treatment?
Doctor :   It is an OTC medication and doesnt need a prescription.
Doctor :   Ok.
User :   Which medicine is an OTC medication?
User :   Is anti-helminthic syrup the name of the medicine or the formula?
Doctor :   Over the counter.
Zentex syrup is given for anti-helminthic treatment and is the trade name and the generic name is Albendazole , which is given to children, but needs a prescription.
Doctor :   It has to be given once and again repeated after 7 days.
User :   Is the effect immediate or within 24 hours?
Doctor :   It is within 24 hrs usually .
User :   Once again, there is no harm in giving this to remove the doubt of worm infestation.
Doctor :   Yes , there is no harm , but has to be given by a Pediatrician, as the weight of the child has to be measured and the dose adjusted accordingly and given under his/her supervision, It is called by different names Zentel,Zentex,Albenza.
Doctor :   Fever; skin rash or itching; sore throat; unusual tiredness and weakness can occur some times.
User :   Doctor, would you be able to recommend the dose if I give you the weight?
User :   She's 11Kg's in weight.
Doctor :   Did you get my answer ?
Doctor :   I am very sorry The prescription medicines are given after the cause is exactly made out or diagnosed, Since I have not physically examined your daughter, it is inappropriate and unethical to prescribe scheduled drugs, and is against the law.Hence I advise you to get a prescription from the Pediatrician.
Doctor :   I have prescribed Maltsupex as It is not a prescription but an OTC Medication.
Doctor :   Hope you understand my constraint.
Doctor :   Treating Constipation with Dietary Modifications :The ultimate goal in treating constipation is for your child to have a soft bowel movement each day.
One of the main ways to prevent and treat constipation is by modifying your child's diet. This includes decreasing foods that are constipating, including cow's milk, bananas, yogurt, cheese, cooked carrots and other foods that are low in fiber. For children that drink a lot of milk, soy milk is a good alternative, as it is usually much less constipating than cow's milk.
Another important dietary change is increasing the amount of fiber in your child's diet. How much fiber does your child need? The usual recommendation is that children should have 5-6 grams of fiber plus their age in years each day. So a 4 year old should have 9-10 grams of fiber each day.
It can be helpful to learn to read nutrition labels to choose foods that are high in fiber. Fruits and vegetables, especially if they are raw and unpeeled, are good choices. Vegetables that are particularly high in fiber include beans, especially baked, kidney, navy, pinto and lima beans, sweet potatoes, peas, turnip greens and raw tomatoes.
Other foods that are good for children with constipation include vegetable soups (lots of fiber and added fluid), and popcorn. It is also important to increase the amount of fluids that your child is drinking. He should have a minimum of 2-3 glasses of water or fruit juices each day. Apple juice, pear and prune juice, or other juices high in sorbitol, are good choices.
Doctor :   Hope you have followed, Is there anything I can help you with ?
Doctor :   Thank you for consulting me, take care, bye for now.
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