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5 year old with stomach pain and constipation. Cure?

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My daughter complains about stomach aches almost every day and has been constipated since she was 8 months old
I told the doctors but just say that she might grow out of it. Should I seek a 3rd opion? She drinks milk but only at most 8oz a day and she is 5yrs old.
Posted Sat, 14 Apr 2012 in Abdominal Pain
Answered by Dr. Poorna Chandra K.S 12 hours later
Hi and thanks for the query.

Most infants do not have any underlying disease causing constipation.

Constipation is particularly common at three times in an infant and child's life: after starting cereal and puréed foods, during toilet training, and after starting school.

Constipation developing after the initial months (in an infant) is mostly secondary to a faulty toilet training. The second reason that needs a mention is lack of fibre in the diet.

Most often it is because of either passing the stool in standing posture or a fissure around the anus. This makes passing stool a painful and unpleasent experience and the child postpones or avoids stooling. Sometimes it is also because of lack of fibre in the diet.

If a physical examination of the anogenital area is normal then retraining will help. Encourage your child to sit on the toilet as soon as they feel the urge to have a bowel movement and give positive reinforcement (a hug, kiss, or words of encouragement) for recognizing the urge and sitting, whether or not the child is successful. A foot support in the form of a stool, which a child can hold if using adult toilet, helps the child to push against as he or she bears down to move their bowels. Squatting posture is the most physiological posture as it opens up the anorectal angle. A regular habit, unhurriness of visiting the loo at a specified time after some oral intake aids in retraining.

Also adding more fibre in the diet and an initial use of laxatives like lactulose, sitz bath and local analgesic gel (in case of a fissure) will help.

Ofcourse a specialist Pediatric Gastroenterologist can give an expert opinion.

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