Abdominal Pain During Bowel Movements in Young Children

Bowel issues - abdominal pain during defecation?

Hello Doctor: My child is currently 3 years and 3 months old.
For the past two to three weeks, he has been experiencing severe abdominal pain during bowel movements, which resolves immediately after he finishes.
His bowel habits (frequency, shape, and color) are normal, and there are no other symptoms.
We consulted a pediatrician who prescribed medications to soften the stool and regulate his gastrointestinal tract, but there has been no improvement.
We have also increased his water intake and encouraged him to eat more fruits and vegetables (such as bananas, apples, and guavas), but this has not helped either; he experiences pain regardless of whether the stool is soft or hard.
I have read various articles suggesting this could be a normal physiological phenomenon, or it might be related to irritable bowel syndrome or Helicobacter pylori, which may require further investigation.
What should we do to resolve this issue? He had been drinking milk but stopped due to a cold.
Could the cessation of milk, and consequently the probiotics it contains, be the reason for his abdominal pain before bowel movements? He has resumed drinking milk for the past two days, but there has been no improvement.
Should we continue giving him milk or avoid it?

Sam, 30~39 year old female. Ask Date: 2017/10/14

Dr. Pei Rensheng reply Pediatrics

Hello! Pain during bowel movements at this age is most commonly associated with constipation combined with anal fissures.
Even after softening the stool, pain may still occur following the development of an anal fissure.
Other potential causes include polyps, hemorrhoids, perianal abscesses, foreign bodies, or other conditions.
The physician may arrange for X-rays and provide symptomatic treatment.
Wishing you health and happiness! Sincerely, Ren Sheng.

Reply Date: 2017/10/14

More Info

Understanding abdominal pain during bowel movements in young children can be quite complex, as it involves various physiological and psychological factors. In your case, your 3-year-old child is experiencing abdominal pain specifically during bowel movements, which resolves after defecation. This symptom can be distressing for both the child and the parents, and it’s essential to explore potential causes and solutions.

Possible Causes of Abdominal Pain During Bowel Movements
1. Functional Gastrointestinal Disorders: One of the most common reasons for abdominal pain during bowel movements in children is functional gastrointestinal disorders, such as functional abdominal pain or irritable bowel syndrome (IBS). These conditions can cause discomfort without any identifiable structural abnormalities.

2. Constipation: Even if the stool appears normal, the child may still be experiencing constipation. Hard stools can cause pain during defecation, and sometimes children may not fully empty their bowels, leading to residual stool that can cause discomfort.

3. Dietary Factors: The diet plays a crucial role in gastrointestinal health. While you mentioned that your child is consuming fruits and vegetables, it’s essential to ensure that the overall diet is balanced and includes adequate fiber. Additionally, the sudden cessation of milk consumption may have affected gut flora, which can influence bowel regularity and comfort.

4. Psychological Factors: Anxiety or fear associated with bowel movements can also lead to abdominal pain. Children may develop a fear of pain during defecation, which can create a cycle of avoidance and increased discomfort.

5. Infections or Inflammation: Although you mentioned that there are no other symptoms, it’s still worth considering that infections (like gastroenteritis) or inflammatory conditions (like appendicitis) could cause pain, even if they are not immediately apparent.

Recommendations for Management
1. Dietary Adjustments: Continue to encourage a diet rich in fiber, including whole grains, fruits, and vegetables. Ensure that your child is drinking plenty of fluids, as hydration is essential for softening stools. If your child has recently resumed drinking milk, monitor how it affects their bowel movements. Some children may be sensitive to dairy, which could exacerbate gastrointestinal discomfort.

2. Regular Bowel Habits: Establish a routine for bathroom visits, encouraging your child to sit on the toilet at regular intervals, especially after meals. This can help create a habit and reduce anxiety associated with bowel movements.

3. Relaxation Techniques: If anxiety is a concern, consider incorporating relaxation techniques, such as deep breathing or gentle abdominal massages, to help ease discomfort.

4. Probiotics: If you suspect that the cessation of milk may have impacted gut health, you might consider introducing probiotics. These can help restore a healthy balance of gut bacteria, which can be beneficial for digestive health.

5. Follow-Up with Healthcare Providers: Since the medications prescribed by your pediatrician did not alleviate the symptoms, it may be beneficial to follow up with a pediatric gastroenterologist. They can provide further evaluation and may suggest additional tests to rule out any underlying conditions.

6. Monitoring Symptoms: Keep a diary of your child’s bowel movements, including frequency, consistency, and any associated pain. This information can be valuable for healthcare providers in diagnosing and managing the issue.

Conclusion
In summary, abdominal pain during bowel movements in young children can stem from various causes, including functional gastrointestinal disorders, dietary factors, and psychological influences. It’s essential to maintain open communication with your child’s healthcare providers and to monitor their symptoms closely. By making dietary adjustments, establishing regular bowel habits, and possibly introducing probiotics, you may be able to alleviate your child's discomfort. If symptoms persist, further evaluation by a specialist may be necessary to ensure that no underlying issues are contributing to the pain.

Similar Q&A

Understanding Toddler Abdominal Pain: Causes and Relief Strategies

My daughter started complaining of stomach pain today (Sunday) around noon, crying loudly every 6-10 minutes, saying her stomach hurt. This continued throughout the afternoon. Due to it being a holiday, we took her to the emergency room. The doctor reviewed the X-ray and indicate...

Dr. Zhang Peixin reply Pediatrics
Hello: The most common cause of abdominal pain in children over one year old is constipation. However, simple constipation rarely causes vomiting; it is more likely to be associated with acute gastroenteritis. You may consult a pediatric gastroenterologist for diagnosis and treat...

Understanding Children's Abdominal Pain and Bloating: Causes and Solutions

Hello Dr. Hsu, I apologize for interrupting your valuable time. I would like to ask you about my child, who has been experiencing abdominal pain every morning for the past month. The school nurse and doctor have said it is due to abdominal distension. I am unsure what this symp...

Dr. Xu Ruihong reply Gastroenterology and Hepatology
There are many causes of abdominal pain in young children, with constipation being the most common. This can lead to bloating, abdominal pain, and poor appetite. It is recommended to help children develop good bowel habits, increase their intake of vegetables and fruits, and ensu...

Understanding Abdominal Pain in Preschoolers: Causes and Dietary Tips

Dr. Chang: May I ask, since my younger sister is in kindergarten and she is around three to four years old, will she still experience colicky abdominal pain? Sometimes she still has a bit of colicky pain at night. Is this related to her diet? I occasionally give her some congee a...

Dr. Zhang Yingwen reply Pediatrics
Children of this age are less likely to experience nighttime abdominal colic. Whether the nighttime crying is related to gastrointestinal issues remains to be confirmed. Abdominal pain in this age group is often associated with bowel irregularities; therefore, if there are issues...

Understanding Abdominal Pain in Children: When to Seek Help

Hello Dr. Huang: I would like to ask you about my 5-year-old niece. For the past two weeks, she has frequently complained of abdominal pain (near the navel), and tests at the hospital have shown no issues. Recently, her appetite has decreased, and she has been unable to eat much....

Dr. Huang Zheming reply Pediatrics
Hello, Xingchen: There are many causes of abdominal pain, most of which include 1. constipation; not having a bowel movement every day 2. air in the intestines 3. gastrointestinal inflammation (such as infectious, bacterial, or appendicitis) 4. hepatitis, nephritis, nephrotic syn...