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My 6 Year Old Daughter Has Been Experiencing Stomach Aches
Question: My 6 year old daughter has been experiencing stomach aches daily for the last two months. Pediatrician said initial bloodwork showed elevated liver enzymes and xray showed inflammation in liver. More bloodwork reflected EBV/mono and abdominal ultrasound came back normal. Been treating as mono with rest and refraining from contact sports. Stomach aches are ongoing on a daily basis.
Sent scans to another radiologist for a second opinion. He called immediately to say that her colon is extremely mottled with stool. My daughter has bowel movements 1-2 times daily, and they are always soft, bordering on loose. I know this because since I had been trying to determine why she was having stomachaches, to rule out constipation, I have been charting her bowel movements.
Had a second xray done this morning, and the pediatrician called to say there's even MORE stool backed up in the colon (it's been three weeks since the initial xray). WHAT is going on?
Pediatrician says my daughter is extremely constipated and must be "cleaned out," and has prescribed a regimen of OTC Miralax and Dulcolax to clean her system out over a three day period. I restated to the pediatrician that my daughter IS having regular and soft bowel movements, and questioned what would cause such a backup. The doctor repeated that she's severely constipated. It has always been my understanding that constipated meant fewer than 2 bowel movements a week and hard/painful stools. Am I wrong?
Besides the obvious inconvenience and discomfort, I am also concerned that so harshly "cleaning out" my daughter's system is going to actually lead to constipation and/or something other type of irritation since there will initially be nothing left. My husband says to just do it.
I would feel better about it if a specialist could confirm that this is the right course of action, and explain why this child could be so backed up, yet still having regular bowel movements. I appreciate your advice, -Sally
Sent scans to another radiologist for a second opinion. He called immediately to say that her colon is extremely mottled with stool. My daughter has bowel movements 1-2 times daily, and they are always soft, bordering on loose. I know this because since I had been trying to determine why she was having stomachaches, to rule out constipation, I have been charting her bowel movements.
Had a second xray done this morning, and the pediatrician called to say there's even MORE stool backed up in the colon (it's been three weeks since the initial xray). WHAT is going on?
Pediatrician says my daughter is extremely constipated and must be "cleaned out," and has prescribed a regimen of OTC Miralax and Dulcolax to clean her system out over a three day period. I restated to the pediatrician that my daughter IS having regular and soft bowel movements, and questioned what would cause such a backup. The doctor repeated that she's severely constipated. It has always been my understanding that constipated meant fewer than 2 bowel movements a week and hard/painful stools. Am I wrong?
Besides the obvious inconvenience and discomfort, I am also concerned that so harshly "cleaning out" my daughter's system is going to actually lead to constipation and/or something other type of irritation since there will initially be nothing left. My husband says to just do it.
I would feel better about it if a specialist could confirm that this is the right course of action, and explain why this child could be so backed up, yet still having regular bowel movements. I appreciate your advice, -Sally
My 6 year old daughter has been experiencing stomach aches daily for the last two months. Pediatrician said initial bloodwork showed elevated liver enzymes and xray showed inflammation in liver. More bloodwork reflected EBV/mono and abdominal ultrasound came back normal. Been treating as mono with rest and refraining from contact sports. Stomach aches are ongoing on a daily basis.
Sent scans to another radiologist for a second opinion. He called immediately to say that her colon is extremely mottled with stool. My daughter has bowel movements 1-2 times daily, and they are always soft, bordering on loose. I know this because since I had been trying to determine why she was having stomachaches, to rule out constipation, I have been charting her bowel movements.
Had a second xray done this morning, and the pediatrician called to say there's even MORE stool backed up in the colon (it's been three weeks since the initial xray). WHAT is going on?
Pediatrician says my daughter is extremely constipated and must be "cleaned out," and has prescribed a regimen of OTC Miralax and Dulcolax to clean her system out over a three day period. I restated to the pediatrician that my daughter IS having regular and soft bowel movements, and questioned what would cause such a backup. The doctor repeated that she's severely constipated. It has always been my understanding that constipated meant fewer than 2 bowel movements a week and hard/painful stools. Am I wrong?
Besides the obvious inconvenience and discomfort, I am also concerned that so harshly "cleaning out" my daughter's system is going to actually lead to constipation and/or something other type of irritation since there will initially be nothing left. My husband says to just do it.
I would feel better about it if a specialist could confirm that this is the right course of action, and explain why this child could be so backed up, yet still having regular bowel movements. I appreciate your advice, -Sally
Sent scans to another radiologist for a second opinion. He called immediately to say that her colon is extremely mottled with stool. My daughter has bowel movements 1-2 times daily, and they are always soft, bordering on loose. I know this because since I had been trying to determine why she was having stomachaches, to rule out constipation, I have been charting her bowel movements.
Had a second xray done this morning, and the pediatrician called to say there's even MORE stool backed up in the colon (it's been three weeks since the initial xray). WHAT is going on?
Pediatrician says my daughter is extremely constipated and must be "cleaned out," and has prescribed a regimen of OTC Miralax and Dulcolax to clean her system out over a three day period. I restated to the pediatrician that my daughter IS having regular and soft bowel movements, and questioned what would cause such a backup. The doctor repeated that she's severely constipated. It has always been my understanding that constipated meant fewer than 2 bowel movements a week and hard/painful stools. Am I wrong?
Besides the obvious inconvenience and discomfort, I am also concerned that so harshly "cleaning out" my daughter's system is going to actually lead to constipation and/or something other type of irritation since there will initially be nothing left. My husband says to just do it.
I would feel better about it if a specialist could confirm that this is the right course of action, and explain why this child could be so backed up, yet still having regular bowel movements. I appreciate your advice, -Sally
Brief Answer:
Detailed investigations are required.
Detailed Answer:
Hello and thanks for asking query on HealthcareMagic,
Have seen your details.
Firstly its not constipation rather it could be impaction.Secondly we need to rule out few diseases and certain tests should be performed to look for the cause of impaction of stools in intestines at such a small age.
See priority of doctor is not treating impaction of stool but to find out the can cause it in child.Even a pharmacist can give miralax or enema.
Firstly look for the basic points
Is he eating enough fiber?
Drinking enough liquids or dehydration?
Other causes which may cause such impaction in child are-
Hirschsprung disease
celiac disease disorders that affect brain and spine, such as spina bifida.
Trauma to spinal cord or brain.
Some conditions that affect their metabolism, such as Type 1 diabetes.
Conditions such as hypothyroidism.
Problems that can block or narrow the colon or rectum, including tumors.
Any problem which may decrease the motility of the intestines.
See one can treat the child giving miralax etc is not a rocket science but 6 years is not a age in which patient should have such problems.
X Ray is just a base line tests
Tests recommended are-
Fecogram-to find out any defect in gut muscle.
Manometry-Measures pressure of anal and rectal canal and helps to find the patency and strenght of muscles.
Ballon evacuation test -demonstatres how easy or difficult is it to pass bowel.
Colonoscopy a must for him.This test involves the ue of camera which is inserted into intestines via rectum and helps to find out problems related to intestinal muscles and their motility.
See it's very easy to treat symptoms even a pharmacist could do that but primary aim of doctor is not to treat rather find out the cause of problem.
Take a print out and discuss this with your treating doctor.
Follow up with what he/she says.
Hope I was helpful,
Follow ups are welcome.
Thanks.
Detailed investigations are required.
Detailed Answer:
Hello and thanks for asking query on HealthcareMagic,
Have seen your details.
Firstly its not constipation rather it could be impaction.Secondly we need to rule out few diseases and certain tests should be performed to look for the cause of impaction of stools in intestines at such a small age.
See priority of doctor is not treating impaction of stool but to find out the can cause it in child.Even a pharmacist can give miralax or enema.
Firstly look for the basic points
Is he eating enough fiber?
Drinking enough liquids or dehydration?
Other causes which may cause such impaction in child are-
Hirschsprung disease
celiac disease disorders that affect brain and spine, such as spina bifida.
Trauma to spinal cord or brain.
Some conditions that affect their metabolism, such as Type 1 diabetes.
Conditions such as hypothyroidism.
Problems that can block or narrow the colon or rectum, including tumors.
Any problem which may decrease the motility of the intestines.
See one can treat the child giving miralax etc is not a rocket science but 6 years is not a age in which patient should have such problems.
X Ray is just a base line tests
Tests recommended are-
Fecogram-to find out any defect in gut muscle.
Manometry-Measures pressure of anal and rectal canal and helps to find the patency and strenght of muscles.
Ballon evacuation test -demonstatres how easy or difficult is it to pass bowel.
Colonoscopy a must for him.This test involves the ue of camera which is inserted into intestines via rectum and helps to find out problems related to intestinal muscles and their motility.
See it's very easy to treat symptoms even a pharmacist could do that but primary aim of doctor is not to treat rather find out the cause of problem.
Take a print out and discuss this with your treating doctor.
Follow up with what he/she says.
Hope I was helpful,
Follow ups are welcome.
Thanks.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Detailed investigations are required.
Detailed Answer:
Hello and thanks for asking query on HealthcareMagic,
Have seen your details.
Firstly its not constipation rather it could be impaction.Secondly we need to rule out few diseases and certain tests should be performed to look for the cause of impaction of stools in intestines at such a small age.
See priority of doctor is not treating impaction of stool but to find out the can cause it in child.Even a pharmacist can give miralax or enema.
Firstly look for the basic points
Is he eating enough fiber?
Drinking enough liquids or dehydration?
Other causes which may cause such impaction in child are-
Hirschsprung disease
celiac disease disorders that affect brain and spine, such as spina bifida.
Trauma to spinal cord or brain.
Some conditions that affect their metabolism, such as Type 1 diabetes.
Conditions such as hypothyroidism.
Problems that can block or narrow the colon or rectum, including tumors.
Any problem which may decrease the motility of the intestines.
See one can treat the child giving miralax etc is not a rocket science but 6 years is not a age in which patient should have such problems.
X Ray is just a base line tests
Tests recommended are-
Fecogram-to find out any defect in gut muscle.
Manometry-Measures pressure of anal and rectal canal and helps to find the patency and strenght of muscles.
Ballon evacuation test -demonstatres how easy or difficult is it to pass bowel.
Colonoscopy a must for him.This test involves the ue of camera which is inserted into intestines via rectum and helps to find out problems related to intestinal muscles and their motility.
See it's very easy to treat symptoms even a pharmacist could do that but primary aim of doctor is not to treat rather find out the cause of problem.
Take a print out and discuss this with your treating doctor.
Follow up with what he/she says.
Hope I was helpful,
Follow ups are welcome.
Thanks.
Detailed investigations are required.
Detailed Answer:
Hello and thanks for asking query on HealthcareMagic,
Have seen your details.
Firstly its not constipation rather it could be impaction.Secondly we need to rule out few diseases and certain tests should be performed to look for the cause of impaction of stools in intestines at such a small age.
See priority of doctor is not treating impaction of stool but to find out the can cause it in child.Even a pharmacist can give miralax or enema.
Firstly look for the basic points
Is he eating enough fiber?
Drinking enough liquids or dehydration?
Other causes which may cause such impaction in child are-
Hirschsprung disease
celiac disease disorders that affect brain and spine, such as spina bifida.
Trauma to spinal cord or brain.
Some conditions that affect their metabolism, such as Type 1 diabetes.
Conditions such as hypothyroidism.
Problems that can block or narrow the colon or rectum, including tumors.
Any problem which may decrease the motility of the intestines.
See one can treat the child giving miralax etc is not a rocket science but 6 years is not a age in which patient should have such problems.
X Ray is just a base line tests
Tests recommended are-
Fecogram-to find out any defect in gut muscle.
Manometry-Measures pressure of anal and rectal canal and helps to find the patency and strenght of muscles.
Ballon evacuation test -demonstatres how easy or difficult is it to pass bowel.
Colonoscopy a must for him.This test involves the ue of camera which is inserted into intestines via rectum and helps to find out problems related to intestinal muscles and their motility.
See it's very easy to treat symptoms even a pharmacist could do that but primary aim of doctor is not to treat rather find out the cause of problem.
Take a print out and discuss this with your treating doctor.
Follow up with what he/she says.
Hope I was helpful,
Follow ups are welcome.
Thanks.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you for taking the time to respond. Please help me understand how my daughter continues to have regular bowel movements (1-2 times daily, and relatively soft) even with this impaction?? How is this possible? Everything I read equates impaction to constipated, and it's simply not the case in my daughter's instance. I don't understand how it's possible that she is able to have normal bowel movements.
Thank you for taking the time to respond. Please help me understand how my daughter continues to have regular bowel movements (1-2 times daily, and relatively soft) even with this impaction?? How is this possible? Everything I read equates impaction to constipated, and it's simply not the case in my daughter's instance. I don't understand how it's possible that she is able to have normal bowel movements.
Brief Answer:
Follow up.
Detailed Answer:
Hello again dear,
A mild degree of impaction could be there.
Secondly as explained earlier there are many things that should be ruled out for e.g. motility of intestine. Contraction and relaxation of intestines. Nerve supplies to the intestine are all fine.
Her X-Ray (Barium swallow, I guess) shows that a large amount of stools is there in her intestines as told by you earlier.
It's not necessary that she is severely impacted; There could be a mild degree of impaction also.
She is a young patient. In her case, the lubrication cells n intestine would secrete a large amount of fluid to make stools soft and pass easily (but this can be done to a certain extent only).
Detailed investigations of the child as suggested above need to be done as suggested earlier.
Question important in her case is that why her doctor is saying that she has a large number of stools in her intestines...
For finding out the answers specific tests need to be done.
Hope you understand,
Follow-ups are welcome.
Thanks.
Follow up.
Detailed Answer:
Hello again dear,
A mild degree of impaction could be there.
Secondly as explained earlier there are many things that should be ruled out for e.g. motility of intestine. Contraction and relaxation of intestines. Nerve supplies to the intestine are all fine.
Her X-Ray (Barium swallow, I guess) shows that a large amount of stools is there in her intestines as told by you earlier.
It's not necessary that she is severely impacted; There could be a mild degree of impaction also.
She is a young patient. In her case, the lubrication cells n intestine would secrete a large amount of fluid to make stools soft and pass easily (but this can be done to a certain extent only).
Detailed investigations of the child as suggested above need to be done as suggested earlier.
Question important in her case is that why her doctor is saying that she has a large number of stools in her intestines...
For finding out the answers specific tests need to be done.
Hope you understand,
Follow-ups are welcome.
Thanks.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
Follow up.
Detailed Answer:
Hello again dear,
A mild degree of impaction could be there.
Secondly as explained earlier there are many things that should be ruled out for e.g. motility of intestine. Contraction and relaxation of intestines. Nerve supplies to the intestine are all fine.
Her X-Ray (Barium swallow, I guess) shows that a large amount of stools is there in her intestines as told by you earlier.
It's not necessary that she is severely impacted; There could be a mild degree of impaction also.
She is a young patient. In her case, the lubrication cells n intestine would secrete a large amount of fluid to make stools soft and pass easily (but this can be done to a certain extent only).
Detailed investigations of the child as suggested above need to be done as suggested earlier.
Question important in her case is that why her doctor is saying that she has a large number of stools in her intestines...
For finding out the answers specific tests need to be done.
Hope you understand,
Follow-ups are welcome.
Thanks.
Follow up.
Detailed Answer:
Hello again dear,
A mild degree of impaction could be there.
Secondly as explained earlier there are many things that should be ruled out for e.g. motility of intestine. Contraction and relaxation of intestines. Nerve supplies to the intestine are all fine.
Her X-Ray (Barium swallow, I guess) shows that a large amount of stools is there in her intestines as told by you earlier.
It's not necessary that she is severely impacted; There could be a mild degree of impaction also.
She is a young patient. In her case, the lubrication cells n intestine would secrete a large amount of fluid to make stools soft and pass easily (but this can be done to a certain extent only).
Detailed investigations of the child as suggested above need to be done as suggested earlier.
Question important in her case is that why her doctor is saying that she has a large number of stools in her intestines...
For finding out the answers specific tests need to be done.
Hope you understand,
Follow-ups are welcome.
Thanks.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you again for your ongoing conversation! Our pediatrician's first step is to "clean out" my daughter's bowels with a combo of Miralax and Dulcolax THIS WEEKEND, and then figure out the cause behind the impaction. Do I proceed as instructed, or should I take my daughter to a pediatric gastroenterologist first?
Thank you again for your ongoing conversation! Our pediatrician's first step is to "clean out" my daughter's bowels with a combo of Miralax and Dulcolax THIS WEEKEND, and then figure out the cause behind the impaction. Do I proceed as instructed, or should I take my daughter to a pediatric gastroenterologist first?
Honestly, as much as I like and respect our pediatrician, I think she's out of her wheelhouse here. She saw the initial xray, and never commented that there was anything irregular with regard to her stool. It wasn't until I relayed the second opinion of a radiologist friend of the family, that she suddenly became the authority on how we must proceed immediately with getting rid of the stool immediately. I'm not doubting that the stool needs to go, but just want to make I'm not skipping steps.
Honestly, as much as I like and respect our pediatrician, I think she's out of her wheelhouse here. She saw the initial xray, and never commented that there was anything irregular with regard to her stool. It wasn't until I relayed the second opinion of a radiologist friend of the family, that she suddenly became the authority on how we must proceed immediately with getting rid of the stool immediately. I'm not doubting that the stool needs to go, but just want to make I'm not skipping steps.
Brief Answer:
Follow up.
Detailed Answer:
Thank you for follow up my dear,
The first step should be to evacuate the bowel. Food would otherwise start fermenting causing bacteria's and year to develop there. This can lead to inflammation and infection of intestines.
After that go for the tests minimum a colonoscopy.
See its very easy to evacuate bowel by giving miralax or enema but 6 years is not a age when this should happen.
So our priority as a doctor is to find out the cause.
Whether you consult a pediatrician or a Gastroenterologist both would do the same set of tests as suggested earlier.
Hope i was helpful,
Feel free to follow up.
Thank you and don't panic.
Follow up.
Detailed Answer:
Thank you for follow up my dear,
The first step should be to evacuate the bowel. Food would otherwise start fermenting causing bacteria's and year to develop there. This can lead to inflammation and infection of intestines.
After that go for the tests minimum a colonoscopy.
See its very easy to evacuate bowel by giving miralax or enema but 6 years is not a age when this should happen.
So our priority as a doctor is to find out the cause.
Whether you consult a pediatrician or a Gastroenterologist both would do the same set of tests as suggested earlier.
Hope i was helpful,
Feel free to follow up.
Thank you and don't panic.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Follow up.
Detailed Answer:
Thank you for follow up my dear,
The first step should be to evacuate the bowel. Food would otherwise start fermenting causing bacteria's and year to develop there. This can lead to inflammation and infection of intestines.
After that go for the tests minimum a colonoscopy.
See its very easy to evacuate bowel by giving miralax or enema but 6 years is not a age when this should happen.
So our priority as a doctor is to find out the cause.
Whether you consult a pediatrician or a Gastroenterologist both would do the same set of tests as suggested earlier.
Hope i was helpful,
Feel free to follow up.
Thank you and don't panic.
Follow up.
Detailed Answer:
Thank you for follow up my dear,
The first step should be to evacuate the bowel. Food would otherwise start fermenting causing bacteria's and year to develop there. This can lead to inflammation and infection of intestines.
After that go for the tests minimum a colonoscopy.
See its very easy to evacuate bowel by giving miralax or enema but 6 years is not a age when this should happen.
So our priority as a doctor is to find out the cause.
Whether you consult a pediatrician or a Gastroenterologist both would do the same set of tests as suggested earlier.
Hope i was helpful,
Feel free to follow up.
Thank you and don't panic.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you!
Thank you!
Brief Answer:
Thank you.
Detailed Answer:
My pleasure dear.
Do rate the answer.
I wish her a good luck.
Thank you.
Thank you.
Detailed Answer:
My pleasure dear.
Do rate the answer.
I wish her a good luck.
Thank you.
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Thank you.
Detailed Answer:
My pleasure dear.
Do rate the answer.
I wish her a good luck.
Thank you.
Thank you.
Detailed Answer:
My pleasure dear.
Do rate the answer.
I wish her a good luck.
Thank you.
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Above answer was peer-reviewed by :
Dr. Kampana
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