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Child holding motion, foul smell, sticky and dark. How to soften her stools?

I have a 4 year old grandaughter who is having problems pooping in the toilet. She holds her poop in & we think it may be because it has hurt her have a BM in the past. The main issue is that the poop is not normal - it smells extremely foul & is very sticky & sometimes dark. She has seen her PCP, a GI dr & an allergist . No food allergies (but she was only skin tested) - no sensitivity testing. Specialists seem to think giving her laxatives & emimas to soften her stool and clear her GI tract for easier stools is the only thing to do. They call it Poop fear . PS. Peeing on the toilet is not an issue for her at all. But she will hold in her poop all day at daycare & then have 2-3 small accidents in the evenings. Any insight?
Asked On : Sun, 16 Dec 2012
Answers:  1 Views:  237
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Pediatrician 's  Response

Holding of stools through out the day might be one of the reasons, as holding causes the stools to become hard, dry and bigger. So its better if she evacuates her bowel as a routine in the mornings before she goes to her day care.

Check with your doctor if she has and Anal Fissures- as anal fissure will cause intense pain and cause fear of passing stools- which in turn leads to holding of stools and that in turn aggravates the constipation. If she has a fissure, it has to be treated with local anesthetic gels and a stool softener for a minimum period of 3 weeks.

Dietary modification is a must. Her diet must contain lot of fiber- fresh fruits, vegetables, fresh fruit juices, soups, food from whole grains etc.
Avoid junk food, tinned food, high fat food, potato, banana etc.
Plenty of plain water should also be given.

Stools when infrequently passed- may themselves cause offensive smell and have a dark color. If its sticky and floats even after correction of constipation, you might have to rule out fat malabsorption.

Yes, as your doctors suggest, she might need laxatives and stool softeners for few weeks.

If problems persist or recur after usage of medications, you doctors will suggest further investigations.

Hope my answer helps you.
Best wishes.
Answered: Mon, 17 Dec 2012
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