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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Severe Constipation Along With Liquid Stool

My 8 year old daughter has cronic constipation. She takes Miralax on a daily basis. She is unable to use the restroom, and has liquid like stool in her underwear. her abdomen is hard and somewhat distended. She has been in and out of the hospital about once a year for the past 5 years. Should we take her into the ER tonight or can we wait until the morning?
Mon, 22 Aug 2016
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General Surgeon,  's  Response
Hi.
Thanks for your query.
Noted the history about your 8 year old daughter having chronic constipation, has to take Miralax, but she is getting liquid stools, in her underwear, abdomen is hard and somewhat distended, wants to know whether to take her to ER.
The combination of distension, liquid stools and hard abdomen suggest that the colon is loaded with fecoliths and the loose stool is getting in underwear.
I would advise you the following in such a situation:
Take her to ER and insist on X-ray of the abdomen in standing position, if the colon is loaded she needs saline+soap enema to clear the fecoliths and she may improve dramatically.
Once cleared, take an appointment for colonoscopy and biopsy to watch for any aganglionic segment, if yes may need surgery to remove the segment of the large bowel which is not innervated.
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Suggest Treatment For Severe Constipation Along With Liquid Stool

Hi. Thanks for your query. Noted the history about your 8 year old daughter having chronic constipation, has to take Miralax, but she is getting liquid stools, in her underwear, abdomen is hard and somewhat distended, wants to know whether to take her to ER. The combination of distension, liquid stools and hard abdomen suggest that the colon is loaded with fecoliths and the loose stool is getting in underwear. I would advise you the following in such a situation: Take her to ER and insist on X-ray of the abdomen in standing position, if the colon is loaded she needs saline+soap enema to clear the fecoliths and she may improve dramatically. Once cleared, take an appointment for colonoscopy and biopsy to watch for any aganglionic segment, if yes may need surgery to remove the segment of the large bowel which is not innervated.