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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Constipation. Why Is Stool Dry? On Deworming Tablets. Why Is BM Painful?

.1 year 8 months (D.O.B. 22-12-2010). Her weight is 10.5kg. and height is 78 cms.the problem is constipation for past 5 months. She has no other health issues past 7 months and no medicine was given during this period.(Except the routine vaccination and also not given medicine for de- worming) She passes motion once in 3 or 4 days only, is having too much pain also during the bowel movement as she cries too much. The stool is too dry, hard and sometimes traces of blood are also seen. About her food habits she eats only very small, only thing she takes regularly is a cup of pap made either of raggi or banana powder, rice or other food she takes only too small that too dry like that without any curry. We are trying to give fruits and vegetables but she never eats. Breast feeding is continuing. There is no problem in passing urine and it is frequent.
Mon, 24 Sep 2012
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Pediatrician, Surgery 's  Response
Dear Ms Kumar

First query is. did your child pass stools normally in the first few days/ weeks after birth.

if she was passing stools regularly initially and only for last 5 months she has constipation, then as you have noted this is definitely linked to her diet. A good diet must include fibre. Fibre is found mainly in fruits and vegetables. As you have indicated, most children will refuse to eat these but one needs to distract them and cajole them and incorporate it into some fun activity like playing or favorite TV program and link it to a reward system. Small quantities of rage or banana powder and rice do not have fibre. You could consider adding green leafy vegetables (palak, etc) in the sambar/ curry. THe reason she sometimes has blood in stools is because the hard stool behaves like small rocks rubbing the gentle lining of her anal passage. This will lead to pain in passing stools and will cause her to hold back further worsening the constipation. I suggest you make her sit in a warm tub with warm water and a handful of salt (Sietz bath) for 15 min in the morning and 15 minutes in the evening. For the first 3 weeks, also add Syr Lactulose 5 ml at night. this acts as a stool softener but the main treatment is the change in diet. All the best. Please keep me informed at robertantony at gmail

Regards
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Constipation. Why Is Stool Dry? On Deworming Tablets. Why Is BM Painful?

Dear Ms Kumar First query is. did your child pass stools normally in the first few days/ weeks after birth. if she was passing stools regularly initially and only for last 5 months she has constipation, then as you have noted this is definitely linked to her diet. A good diet must include fibre. Fibre is found mainly in fruits and vegetables. As you have indicated, most children will refuse to eat these but one needs to distract them and cajole them and incorporate it into some fun activity like playing or favorite TV program and link it to a reward system. Small quantities of rage or banana powder and rice do not have fibre. You could consider adding green leafy vegetables (palak, etc) in the sambar/ curry. THe reason she sometimes has blood in stools is because the hard stool behaves like small rocks rubbing the gentle lining of her anal passage. This will lead to pain in passing stools and will cause her to hold back further worsening the constipation. I suggest you make her sit in a warm tub with warm water and a handful of salt (Sietz bath) for 15 min in the morning and 15 minutes in the evening. For the first 3 weeks, also add Syr Lactulose 5 ml at night. this acts as a stool softener but the main treatment is the change in diet. All the best. Please keep me informed at robertantony at gmail Regards