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XXXXXXX Is Always Constipated, She Had Encopresis As A Toddler,
Question: XXXXXXX is always constipated, she had encopresis as a toddler, but we thought that was gone since she was on miralax for a year and began to have bowel movements on her own. But it seems she is having a problem again. It's sad how uncomfortable she is. Can the encopresis come back if she stretches out that pouch again, and not get the urge to go?, so do her bowel movements get too big and painful to pass? She is now almost 11. She has a good diet, eats good food, eats a lot of fruit, drinks water, but also eats a lot of junk too, but not instead of good food.
XXXXXXX is always constipated, she had encopresis as a toddler, but we thought that was gone since she was on miralax for a year and began to have bowel movements on her own. But it seems she is having a problem again. It's sad how uncomfortable she is. Can the encopresis come back if she stretches out that pouch again, and not get the urge to go?, so do her bowel movements get too big and painful to pass? She is now almost 11. She has a good diet, eats good food, eats a lot of fruit, drinks water, but also eats a lot of junk too, but not instead of good food.
Brief Answer:
Functional constipation likely
Detailed Answer:
Hi dear,
When did the present episode started?
Is there any anal fissures/blood streaking of stool?
Any investigations done before?
Any recent drug intake?
It is good that the constipation started after 2 years, she is otherwise growing well, and was symptom free for a long time until now. These features suggest functional constipation- means that, chance of a significant underlying cause like anatomical abnormalities bowel is very unlikely. Still, I used to get a thyroid profile, serum calcium and sometimes a contrast x ray done in recurring cases.
Since there is fecal impaction with encopresis now, this needs initial fecal disimpaction, followed by maintenance therapy with a laxative for few months. I usually prefer polyethylene glycol(miralax). I give 1g/kg morning and evening for 3-5 days, followed by once daily for 8-12 months. Your doctor will guide in this. We can gradually taper and stop after obtaining good response.
There is no particular cause for functional constipation. Some contributing factors are:
1. Low residue diet: Increase fibre rich items and reduce baked items/junk foods.
2. Inadequate water intake.
It is good that she is taking enough fibres and fluids
3. Voluntary holding of bowel (as in school or while going out).
4. Excessive dairy items in diet
5. Frequent use of some drugs like cough syrups, antispasmodics.
In short: There is nothing to worry much as an underlying significant cause is unlikely. Probably we can taper and stop laxative after normalising motion. Try to find out and correct any contributors as mentioned.
Let me know if I can assist you further
Wishing you good health
Functional constipation likely
Detailed Answer:
Hi dear,
When did the present episode started?
Is there any anal fissures/blood streaking of stool?
Any investigations done before?
Any recent drug intake?
It is good that the constipation started after 2 years, she is otherwise growing well, and was symptom free for a long time until now. These features suggest functional constipation- means that, chance of a significant underlying cause like anatomical abnormalities bowel is very unlikely. Still, I used to get a thyroid profile, serum calcium and sometimes a contrast x ray done in recurring cases.
Since there is fecal impaction with encopresis now, this needs initial fecal disimpaction, followed by maintenance therapy with a laxative for few months. I usually prefer polyethylene glycol(miralax). I give 1g/kg morning and evening for 3-5 days, followed by once daily for 8-12 months. Your doctor will guide in this. We can gradually taper and stop after obtaining good response.
There is no particular cause for functional constipation. Some contributing factors are:
1. Low residue diet: Increase fibre rich items and reduce baked items/junk foods.
2. Inadequate water intake.
It is good that she is taking enough fibres and fluids
3. Voluntary holding of bowel (as in school or while going out).
4. Excessive dairy items in diet
5. Frequent use of some drugs like cough syrups, antispasmodics.
In short: There is nothing to worry much as an underlying significant cause is unlikely. Probably we can taper and stop laxative after normalising motion. Try to find out and correct any contributors as mentioned.
Let me know if I can assist you further
Wishing you good health
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
Functional constipation likely
Detailed Answer:
Hi dear,
When did the present episode started?
Is there any anal fissures/blood streaking of stool?
Any investigations done before?
Any recent drug intake?
It is good that the constipation started after 2 years, she is otherwise growing well, and was symptom free for a long time until now. These features suggest functional constipation- means that, chance of a significant underlying cause like anatomical abnormalities bowel is very unlikely. Still, I used to get a thyroid profile, serum calcium and sometimes a contrast x ray done in recurring cases.
Since there is fecal impaction with encopresis now, this needs initial fecal disimpaction, followed by maintenance therapy with a laxative for few months. I usually prefer polyethylene glycol(miralax). I give 1g/kg morning and evening for 3-5 days, followed by once daily for 8-12 months. Your doctor will guide in this. We can gradually taper and stop after obtaining good response.
There is no particular cause for functional constipation. Some contributing factors are:
1. Low residue diet: Increase fibre rich items and reduce baked items/junk foods.
2. Inadequate water intake.
It is good that she is taking enough fibres and fluids
3. Voluntary holding of bowel (as in school or while going out).
4. Excessive dairy items in diet
5. Frequent use of some drugs like cough syrups, antispasmodics.
In short: There is nothing to worry much as an underlying significant cause is unlikely. Probably we can taper and stop laxative after normalising motion. Try to find out and correct any contributors as mentioned.
Let me know if I can assist you further
Wishing you good health
Functional constipation likely
Detailed Answer:
Hi dear,
When did the present episode started?
Is there any anal fissures/blood streaking of stool?
Any investigations done before?
Any recent drug intake?
It is good that the constipation started after 2 years, she is otherwise growing well, and was symptom free for a long time until now. These features suggest functional constipation- means that, chance of a significant underlying cause like anatomical abnormalities bowel is very unlikely. Still, I used to get a thyroid profile, serum calcium and sometimes a contrast x ray done in recurring cases.
Since there is fecal impaction with encopresis now, this needs initial fecal disimpaction, followed by maintenance therapy with a laxative for few months. I usually prefer polyethylene glycol(miralax). I give 1g/kg morning and evening for 3-5 days, followed by once daily for 8-12 months. Your doctor will guide in this. We can gradually taper and stop after obtaining good response.
There is no particular cause for functional constipation. Some contributing factors are:
1. Low residue diet: Increase fibre rich items and reduce baked items/junk foods.
2. Inadequate water intake.
It is good that she is taking enough fibres and fluids
3. Voluntary holding of bowel (as in school or while going out).
4. Excessive dairy items in diet
5. Frequent use of some drugs like cough syrups, antispasmodics.
In short: There is nothing to worry much as an underlying significant cause is unlikely. Probably we can taper and stop laxative after normalising motion. Try to find out and correct any contributors as mentioned.
Let me know if I can assist you further
Wishing you good health
Above answer was peer-reviewed by :
Dr. Prasad
Thank you for that information. It's difficult to know if she holds it in until a particular opportunity to go, however your suggestion of too much dairy could be a possible culprit, as she does drink a lot of milk and likes cheese, which I know causes constipation. Question; are processed cheeses worse for constipation than hard cheeses?
Thank you for that information. It's difficult to know if she holds it in until a particular opportunity to go, however your suggestion of too much dairy could be a possible culprit, as she does drink a lot of milk and likes cheese, which I know causes constipation. Question; are processed cheeses worse for constipation than hard cheeses?
Brief Answer:
No much difference
Detailed Answer:
Hi dear,
In my opinion, there won't be much difference between processed and hard cheese as far as constipation is concerned, as they differ only in moisture content, emulsifiers, and preservatives
It will be fine if we can make it a habit to have regular toilet sittings after food, in the morning and evening. Even if no motion is passed during the initial few days, this will help to gradually establish a routine.
Hope I have answered your query.
If you need further clarification, I will be happy to help.
Take care
No much difference
Detailed Answer:
Hi dear,
In my opinion, there won't be much difference between processed and hard cheese as far as constipation is concerned, as they differ only in moisture content, emulsifiers, and preservatives
It will be fine if we can make it a habit to have regular toilet sittings after food, in the morning and evening. Even if no motion is passed during the initial few days, this will help to gradually establish a routine.
Hope I have answered your query.
If you need further clarification, I will be happy to help.
Take care
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
No much difference
Detailed Answer:
Hi dear,
In my opinion, there won't be much difference between processed and hard cheese as far as constipation is concerned, as they differ only in moisture content, emulsifiers, and preservatives
It will be fine if we can make it a habit to have regular toilet sittings after food, in the morning and evening. Even if no motion is passed during the initial few days, this will help to gradually establish a routine.
Hope I have answered your query.
If you need further clarification, I will be happy to help.
Take care
No much difference
Detailed Answer:
Hi dear,
In my opinion, there won't be much difference between processed and hard cheese as far as constipation is concerned, as they differ only in moisture content, emulsifiers, and preservatives
It will be fine if we can make it a habit to have regular toilet sittings after food, in the morning and evening. Even if no motion is passed during the initial few days, this will help to gradually establish a routine.
Hope I have answered your query.
If you need further clarification, I will be happy to help.
Take care
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you for that information about cheeses and establishing a routine. We will give that try.
Thank you for that information about cheeses and establishing a routine. We will give that try.
Brief Answer:
Fine
Detailed Answer:
Hi,
That will be fine.
Even though it may feel cumbersome for initial few days, once established, this will help her a lot. Stool become tighter and tighter as long as it stays inside. Hence regular emptying is very important.
If you do not have further queries, you can close the thread and kindly rate the answer. I look forward to answer your future queries on child health. Wish you good health
Dr Muhammed Aslam, Paediatrician
Fine
Detailed Answer:
Hi,
That will be fine.
Even though it may feel cumbersome for initial few days, once established, this will help her a lot. Stool become tighter and tighter as long as it stays inside. Hence regular emptying is very important.
If you do not have further queries, you can close the thread and kindly rate the answer. I look forward to answer your future queries on child health. Wish you good health
Dr Muhammed Aslam, Paediatrician
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
Fine
Detailed Answer:
Hi,
That will be fine.
Even though it may feel cumbersome for initial few days, once established, this will help her a lot. Stool become tighter and tighter as long as it stays inside. Hence regular emptying is very important.
If you do not have further queries, you can close the thread and kindly rate the answer. I look forward to answer your future queries on child health. Wish you good health
Dr Muhammed Aslam, Paediatrician
Fine
Detailed Answer:
Hi,
That will be fine.
Even though it may feel cumbersome for initial few days, once established, this will help her a lot. Stool become tighter and tighter as long as it stays inside. Hence regular emptying is very important.
If you do not have further queries, you can close the thread and kindly rate the answer. I look forward to answer your future queries on child health. Wish you good health
Dr Muhammed Aslam, Paediatrician
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Raju A.T
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