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Question
Dear Sir,

My son is 2 and a half yrs old. He had constipaton problems 6 months ago and had to deal with hard stools and had problems passing it. That time we consulted his doctor and he gave some laxatives and the problem was solved, but form that time onwards he is fearing to pass the stools. Every time he feels the pressure in the bowels he cries and says "I dont want to do latrine". Than around 10 days ago he stopped to pass the stools. He ate everything but did not do latrine. We again consulted the doctor, he examined the anal opening and said there was no problems like scratches or so. We even did some urine and blood reports. But he found nothing wrong.

He than initiated a course that cause controlled diarrhea. But till today (5 days than) he hasnt passed his stools. His eating is reduced to half. Doctor says its a mental problem and is just feared in getting hurt by passing stools.

Relatives sujjested to give enema. what's this and will it help? Please guide. Also please tell what kind of enema will be suitable for this age.

Please Help...
Thanks..

Answer
Dear Vishal,

There is an entity called Idiopathic Constipation of Infancy and Childhood. Some children just do not pass regular bowel movements without the use of laxatives; then again, we do get psychological stress leading to fear of bowel movements and constipation as a secondary result. In both cases, laxatives are recommended. If the problem causes distension of the stomach and pain, we relieve the problem with insertion of a liquid from the anal site upwards. This is known as an enema. Our ancestors used to put soap or a soapy suspension of water inside the anus and stimulate the passage of a motion. Modern enemas contain a concentrated solution of common salt in water or some other chemical. There is a third option and that is arranging with the local pharma company to supply you those small,child-sized suppositories. All you have to do is to insert one of these into your son's rectum, then keep his legs by each-other's side for about 15-30 minutes. At the end of this wait, the child's stools will be passed naturally.

Once he has passed a large quantity of stool, whether with a suppository or an enema, take him non-urgently to a paediatrician to start ongoing therapy for his problem.

With best wishes,

Dr. Taher

Pediatrics

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Dr. Taher Kagalwala

Expertise

I come from India, and have been practising since 29 years. I am specially interested in infections, asthma, newborn care and parenting. I have authored a book on Parenting.It is called "Child Care: From Birth to Eighteen". The e-book is now available on http://pothi.com/pothi/book/ebook-dr-taher-y-kagalwala-child-care-birth-eighteen.
and on Amazon.com and all local versions, including www.amazon.in. I have my professional site at Blogger. Here, you can read good advice and also seek a professional online consultation for a small fee. Do check out http://drtaherforkids.blogspot.com.

Experience

Qualified Pediatrician practising since 29 years.
Currently working in the United Kingdom. You may reach me on my cell number +447440622670 or email me on drtaher@gmail.com only if I have not responded to your query here in a reasonable time. If you directly call me or email me, I might not be able to respond. Thank you for understanding. Please do not Whatsapp me.

Organizations
Indian Academy of Pediatrics, life member. Mumbai Branch of the I.A.P., life member. Genetics Chapter of the I.A.P.

Publications
Indian Pediatrics, Indian Journal of Pediatrics, Toxicology Abstracts.

Education/Credentials
M.D., M.R.C.P.C.H. (U.K.), Ph. D. (U.S.A.) D.C.H.

Awards and Honors
Gold Medallist in D.C.H., April, 1985
Highest aggregate marks in University of Mumbai, for M.D. ( Pediatrics ), October 1986.
Passed out with distinction from the Royal College of Paediatrics and Child Health, U.K. in 2015.

Past/Present Clients
1. Municipal Corporation of Greater Mumbai (K.E.M. Hospital) 2. Private consulting practice. Worked as the Asst. Paediatrician and DNB Teacher at Masina Hospital. Also visiting Saifee Hospital, Mumbai. 3. Ministry of Health in Kingdom of Saudi Arabia as a Specialist Paediatrician. 4. Now with the NHS, UK as a Specialist Paediatric Registrar at Blackpool, Lancashire, UK.

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