Question: Hi. My son is 4 yr old has been having constipation since past 2 yrs. As a child he used to have regular bowels every day in his diaper. Once he was off the diapers he started passing alternate days. He i still not potty trained and sits on flush yet not able to pass stool. He used to pass stool standing only and even today he does same. Last 2 months it has worsened with him passing stool on after 6 days. On 6th day there is heavy liquid discharge and on 7th day he passes a big lump and then his system clears. We had used lactulose in the past and also laxopeg for 6/months in the past when he was 3 but then decided to let it be as it is and he was passing stool every 2-3 days. Sometime in sleep also he used to pass stool
He has this habit of holding stool if hes playing or busy and hides ans pulls back the stool.This time it was bad as he had nausea and vomiting on 6th day and we gave him dulcolax suppository twice the 7th day. After that the doctor asked to get his usg abdomen done where his entire large bowel was full of gas and potty. Also his rectum was distended. Doctor gave him enema whicj was not succesful as he had closed his inside tightly. That night every 15/mins he passed stool and only next morning he passed stool which was a dry lump. I could see this big piece inside the anus as it had become wide and open. We consulted a doctor now who told us that we need to stop his milk intake as he was having 2/bowls.of milk XXXXXXX and one cup of milk a day firstly. Apart from this he used to have dal roti,khicdi,etc. he asked us to start one scoop of muout laxative every nite for 90 days. Apart from milk he has asked us to add few veggies and fruits like banana to his diet. Now it's been 3 days and again we find his tummy getting heavy which is concerning me. Doctor is asking for going for barium enema to rule out hursh sprung even though he feels that this is not the case.pls suggest us a line of treatment. He is a fussy eater and doesn't eat fruits though now we have started banana. Do u think we should continue with current approach or try for going for barium enema which mite traumatize him. We have also been asked to give glycerine suppositories but since enema was done he is not allowing anyone near his buttocks. Otherwise he is active and good in his class.Thanks

Thanks doctor. I have made the dietary changes as advised - giving him oats twice a day half bowl. added XXXXXXX to his rotis, giving bananas and veggies with roti and dal. milk is only now 100ml and paneer paratha. some digestive biscuits if he feels like and probiotic drink yakult. This is the diet from past 3-4 days. however he passed stool last on Thursday full day loose motion then Friday he passed hard piece and he cleared up. little bit on Saturday but after that he has not done anything. today is the 4th day ending. while I understand dietary changes do take time, is it advisable at this time to do something else as even enema doctor told me wont help since he had shut himself tight inside so water came out without any impact. as of now he is active and not feeling any urge. his pediatric told me that since he has soiling in his clothes he doesn't seem to be a case of hursh sprung and did not advise for thyroid tests.he has asked me to meet a clinical phsycologist,.