Brief Answer: Assesment by Pediatric Surgeon Detailed Answer: Namasthe Welcome to Healthcare-Magic Greetings of the day I assume by Salmonella infection you meant Non-enteric Salmonellosis. Some infants tend to develop persistent carrier state and tend to excrete the bacteria, without having any active disease. Many will be temporary carriers in the absence of anatomical abnormality of gut and bladder. If they are stil carriers for a long time, it is necessary to erradicate the infection by appropriate use of antibiotic basedon culture and antibiotic sensitivity report. The lactose intolerance would possibly be due to cow milk protein allergy he could have developed( i presume you must have given him cow milk). Before initiation of whole milk again, trial of giving him milk in the form of curd/yoghurt or buttermilk can be tried , in case he accepts it well then slowly whole milk can be given. Coming to the complaint of your 7 year. Being a Pediatric Surgeon, i get many such references for management of Constipation from my Pediatric colleagues. In case of your child i would like to rule out the following( i usually follow this protocol for the children i manage) 1. Fissure in ano; A small ulcer at the anal verge could possibly be cause of constipation 2. Review of dietic history and ruling it out as cause of constipation: Its the most important cause of constipation in older children 3. Remote possibility of Hirschsprung's disease: Depending on per rectal examination findings and also if the child does not respond to diet and other lifestyle modification 4. Hypothyroidism Majority of the cause of constipation in children is related to diet factors. Its more common among those children who have the following 1. Diet mainly consists of milk based feeds 2. Decreased intake of wate 3. Intake of low fiber diet/constipating diet I would suggest you the following which will definitely help 1. Reassessment of symptoms by Pediatric Surgeon: Who would like to rule out fissure in anus or Hirschsprung's disease as cause of symptoms 2. Ensuring adequate intake of water: One cup of plain water 1 hour before and one hour after feeds will ensure adequate intake of water which will help in making the consistency of stools soft 3. High fiber diet: 2 serving of vegetable salad and citrus fruits a day will be very helpful in ensuring adequate fiber intake In case you neeed any further assistance will be glad to assist you. Take Care Best Regards Dr Deepak Kishore MBBS,MS,MCH Consultant Pediatric Surgeon

---