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Child having constipation and many times stomach pain. Prescribed with barium enema test. Any alternate medicine?

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Pediatrician, Surgery
Practicing since : 2003
Answered : 246 Questions
My son is four and half years old. His weight is about 13 kgs. He eats little food and hardly any fibre. He often has constipation and many times stomach pain. We have consulted several paediatricians . One examined his anal passage with fingers and opined that it was okay. Then to rule out any problem in stomach he prescribed Barium enema test to be taken on empty stomach. My query is this test suitable for children, are there any other/alternative tests that he should undergo to rule out stomach problems
Posted Sun, 19 May 2013 in Digestion and Bowels
Answered by Dr. Anand Sinha 1 hour later

Thank you for posting your query on Health Care Magic.

1. Regarding your query about safety of Barium enema
Barium enema is a very safe test. It is just like an X-Ray (so some radiation is there but it is acceptable) except that the doctor introduces a XXXXXXX through his anal opening before taking his X-Rays. So you need not worry regarding the safety. We do these tests day in and day out without any problems

2. Regarding your son's problem
The various causes of constipation in young children include
a. Dietary: Due to diet lacking in fibers
b. Hypothyroidism: Decreased activity of thyroid gland also results in constipation in children
c. Hirschsprung's disease: this is what your pediatrician must be suspecting. It is a condition in which a part of the child's intestine is not able to propel stool forward and hence the child develop constipation. Chronic constipation leads to accumulation of hard stools in the intestine and hence decreases the child's appetite and cause pain in the abdomen.
d. Anal fissure: It is crack near the anal opening which results in pain and bleeding during passing stool and hence constipation. Since your child has been examined and found to have nothing I will rule that out.

Hirschsprung's disease is diagnosed with a Barium enema. There is no alternative test for that. If the barium enema is suggestive or doubtful of Hirschsprung's disease, then we move forward and do a biopsy to confirm the diagnosis. An anorectal manometry (measuring the pressure generated inside the anal canal) can also be done to support diagnosis. The treatment is surgical which involves excision of the part of the intestine, which is not functioning.
You should consult a pediatric surgeon for this problem.
And you should not worry regarding the Barium enema. It is a safe test.

Until you get the results, I also suggest you take the following measures. If the constipation is just dietary, it will respond.
1. Encourage your child to take a lot of fluids
2. Encourage diets with lots of fibers like fruits, green leafy vegetables, carrots etc.
3. Avoid junk food especially the ones with refined and processed foods like refined flour (maida etc)
4. Sweeten his milk by adding some additional sugar. Give him some honey
These measures should help. Also if not yet done, get his thyroid function test too.

Hope that solves your query
God bless you
Dr Anand Sinha
MS General Surgery
MCh Pediatric Surgery
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