Brief Answer: Possibly due to gastroenteritis Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Dear Ms Being a Parent and Pediatric Surgeon, I understand your concern and apprehension. Let's analyse her complaint. Pain. In abdomen while passing stools could be due to many reasons. It could be due to 1. Intestinal colic: Non specific intestinal colic can also have these complaint 2. Constipation 3. Loose stools 4. Presence of redness and inflammation in area surrounding the anus due to loose stools 5. Presence of colitis As your daughter is having loose stools along with bleeding and excessive crying while passing stools. It likely she has colitis ( inflammation of the colon) and the loose stools must have caused redness and erythema in the region surrounding the anus. I would suggest you to have a look at anus to look for redness. Loose motion that is acute gastroenteritis in children is usually self limiting and is caused by rota virus. It requires supportive care to prevent dehydration and prevent local and systemic complication Ad she is not liking commercial oral rehydration solution and also is not accepting feeds well I would suggest you the following 1. Being a Pediatric Surgeon i would definitely be cautious when any child comes with bleeding in the stools. I would advise you to have a look at the anus, excoriation or redness in the skin around the anus opening usually due to loose stool induced could be cause of bleeding. It would just cause very little bleeding. Kindly let me know the amount of bleeding and the anus finding. It would be very helpful if you could elaborate in detail. If there is redness , local application of Siloderm ointment will be very helpful. 2. Ensure good oral intake: Is she vomiting or continuously crying? If she is not accepting commercial oral rehydration solution, it'd okay*majority of the kids won't accept it as it tastes like tears. In that case home made oral rehydration solution may be used. Dhal water with salt added, tender coconut water, to a glass of water add 2 spoons of sugar , pinch of salt and 3 drops of lemon. Feed her using watti and spoon. 3. Colimex drops : It will relieve colic pain and as well as release the gas . Loose stools is also associated with excessive, children are irritable when the gases are not expelled. 0.5 ml three times a day will be helpful 4. Syrup Lanzol kid ; it will help in treating the associated gastritis. 1 ml once a day. 5. Syrup Metrogyl: 10 mg per kilogram body weight per dose given thrice a day for 5 days. It's an antibiotic and will help dysentery. 6. Syrup Neutrolin B : 5 ml twice a day. It's a probiotic. If you notice any of the following then it's advisable to consult you Pediatrician at earliest 1. XXXXXXX bleeding 2. Does not accept feeds at all 3. Notice dehydration: pinch and release the skin on the forearm if it goes back quickly it indicates skin turgor is maintained and there is no dehydration. Look if the tongue is moist. 4. Vomiting or abdominal distension Do get back to me with the details. You can contact me anytime for any further support or guidance. Do not worry will take care if the things. Keep me informed about the progress. Wishing your daughter a speedy recovery. Take care Best Regards Dr Deepak Kishore MBBS, MS, MCH Consultant Pediatric Surgeon

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