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Child is suffering from constipation. Stool test showed no signs of infection. What should I do next?

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Pediatrician, Critical Care
Practicing since : 2001
Answered : 208 Questions
My baby girl XXXXXX, aged 26 months, weighing 11 kg had been having severe constipation since birth. But of late, for the past 2 weeks she is passing motion 4-5 times day. Stools are semi solid yet not watery. Stool routine and culture did not show any signs of infection, and my pediatrician advised us to not to worry and treat it like her normal frequency of motion. Would you suggest any further tests or investigation, or should we just ignore this.
Posted Sun, 21 Apr 2013 in Child Health
Answered by Dr. Tejas Shah 8 hours later
Thanks for posting & directing your query to myself.

Long-standing constipation (present since birth) does need to be investigated. If the investigations turn out to be normal, then only it can be labelled as functional constipation (where there is no organic cause).

I would like to know:
1. When you say constipation, does it mean hard stools, but passing everyday or passing once every few days?
2. Was the constipation present even when she was breastfed in first 4-6 months of life?
3. Does her tummy get distended which upsets her?
4. Is she been gaining weight properly?
5. When she started walking, climbing, running, talking (i.e. was her development age appropriate)?

Constipation since birth has numerous causes including low function of Thyroid (hypothyroid), Calcium disturbances in the body, bowel motility problem etc.

However, based on the fact that she has started to pass motions 4-5 times a day and stool examination is normal, I feel something has changed in herself and constipation is getting relieved. Either there is change in dietary habits, increased intake of fluid or addition of any medications.

Since how long she has been on Tonoferone?

I would not do any further investigation at this juncture.

Please do revert back with answers to your queries and will be glad to resolve this.

Dr Tejas Shah

Above answer was peer-reviewed by
Follow-up: Child is suffering from constipation. Stool test showed no signs of infection. What should I do next? 36 hours later
Thanks for the response doctor.
To answer your questions one by one
1. Her tummy gets distended when she does not pass motion for a day or so.
2. She weighs ~11 kgs at 24 months. Has been steady at 10 kg to 11 kg for nearly 8 months now
3. She shows normal developmental signs, except that she has not started speaking meaningful words. She just mumbles in her own language
4. Her mom (and grand mom) has hypothyroid and is on eltroxin since childhood.

My Pediatrician has put her on cefixime 2.5 ml twice a day for three days, after which frequency of motion has come down to 2 times a day, and she is eating better.

Please let me know your thoughts.
Answered by Dr. Tejas Shah 1 hour later
Thanks for coming back to me.

I am glad to know her stool frequency is coming down and she has started to eat better.

It is interesting to know that her mom has been on Eltroxin since childhood. I would suggest getting thyroid status of your daughter checked within next couple of weeks (There are certain Thyroid diseases, which run in family, it's not serious but needs to be investigated and treated).

Along with weight, we need to look at growth of her height and head circumference to see whether her growth is age appropriate or not. Your Pediatrician may have done that. If the height and head circumference are growing appropriately, it suggest she is getting enough from nutrition point of view.

Please get her weight, height and head circumference checked at 3-6 monthly interval and compare with previous measurements. If there is any faltering in her growth, she would need detailed growth evaluation by a Pediatrician.

I hope I have been able to guide and resolve your query. Please leave me feedback which other parents like yourself can see.

All the best

Dr Tejas Shah
Above answer was peer-reviewed by
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