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Child having loose motion, abdominal pain and loss of appetite. How to cure this problem?

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Pediatrician, Pulmonology
Practicing since : 1974
Answered : 66 Questions
From past 4-5 months my son is passing the motion in under garments. He used to express it when motion sensation comes, but he is not telling most of the times.
The following are observations made when he is unaware of motion sensation.
1) Passing motion in the under garments without his knowledge.
2) Looks like constipation problem as motion passed is in high solid state and small amounts.
3) complaining Abdominal pain
4) Loss of appetite
5) Scratching the anal area and complaining irritation
6) Feeling tired

I am not sure but these symptoms looks like Encopresis. Can you please guide me in resolving this problem?

Posted Sat, 6 Oct 2012 in Child Health
Answered by Dr. K. C. Pant 38 minutes later

Thanks for the query.

Yes, your child seems to be suffering from Encopresis.

He needs to be treated by enemas, laxatives, or both. This can be done by use of oral stool softeners like Lactulose, mineral oil, etc. Following that, enemas and laxatives are used daily to keep the stools soft and allow the stretched bowel to return to its normal size.

The child must be trained to use the toilet regularly and to retrain his body. It is usually recommended that a child be required to sit on the toilet at a regular time each day and may try to go for 10–15 minutes, usually soon after eating. Children are more likely to be able to expel a bowel movement right after eating. This will allow the child to achieve a proper elimination pattern.

Alternatively a more aggressive approach may be undertaken using suppositories and enemas in a planned way. Failure to establish a normal bowel habit can result in permanent stretching of the colon.

Dietary changes are an important. Recommended changes to the diet in the case of constipation-caused encopresis include:

* Reduction in the intake of constipating foods such as dairy, peanuts, and bananas
* Increase in high-fiber foods such as XXXXXXX whole wheat products, fruits, and vegetables and salad.
* Higher intake of water and liquids, such as juices.
* Limit drinks with caffeine, such as cola drinks and tea
* Provide well-balanced meals and snacks, and limit fast foods that are high in fats and sugars
* Limit whole milk to 250 ml a day for the child over 2 years of age, but do not completely eliminate milk because children need for growth. Curd is useful.

Hopefully with these measures he will show good response. Let me know if you have other concerns.

Above answer was peer-reviewed by
Follow-up: Child having loose motion, abdominal pain and loss of appetite. How to cure this problem? 9 hours later
Thank you very much sir. I think I need to restrict my kid in eating junk food, which is the root cause for the problem. I will try to follow the diet changes and will observe the behaviour further.
As he is passing the motion everyday (but with hard stool), I don't think he need any enema. Only thing is can I use Ducolax syrup to soften the stool? If so how many days should you recommend?

Answered by Dr. K. C. Pant 6 hours later
Thank you very much XXXXXXX.

You have rightly said junk food should be totally avoided and follow the advice as given regarding fluids, juices and soups. Yes, you may use lactulose-containing laxative like Dulcolax safely for 2 months.

Also, apply Vaseline petroleum jelly and anti fungal cream in anal region to avoid irritation. Some herbal syrup for liver are useful in constipation and for good appetite and you can give twice before food.

Give one dose anti worm syrup once in 6 months.

I hope that this helps you. Thank you once again.

Above answer was peer-reviewed by
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