Gastrointestinal Issues in Children: A Parent's Guide

Gastrointestinal issues

Hello Doctor: My son is 6 years old.
Recently, for the past two to three months, he has told me about 4 to 5 times that his bottom feels wet.
When I check, I find that it is indeed slightly moist and has a bit of a stool color, just a little bit.
Is this watery stool? He hasn't experienced this before, but for some reason, it has happened several times lately.
Each time this occurs, I ask him to use the bathroom, and after he does, he no longer has that sensation.
His stool is yellow-brown and mushy after he goes.
Is this normal for my son, or could there be a gastrointestinal issue? Should I take him to see a doctor? He has never had this issue before, and it has happened 4 to 5 times in the last two to three months, so I am a bit worried and would like to ask for your advice.
Thank you!

ELLE, 30~39 year old female. Ask Date: 2016/03/14

Dr. Xiao Kaiwen reply Pediatrics

It appears to be encopresis, which is characterized by having more or harder stools that are not completely evacuated, leading to fecal retention in the rectum.
This results in slightly loose stools that can only seep out in small amounts.
A visit to a pediatric gastroenterology department at a major hospital for evaluation is recommended, where a simple abdominal X-ray can determine if there is fecal impaction in the rectum.

Reply Date: 2016/03/14

More Info

It sounds like you are understandably concerned about your son's recent gastrointestinal symptoms. Based on your description, your son has been experiencing episodes of wetness around the anal area, which you noted has a slight color resembling stool. This has occurred several times over the past few months, and you mentioned that after he has a bowel movement, the wetness resolves. The stool itself has been described as yellowish-brown and somewhat watery.

Firstly, it is important to understand that children can experience a variety of gastrointestinal issues, and changes in bowel habits can be common. The symptoms you describe could potentially be related to several factors, including diet, hydration, and even stress or anxiety. Here are some considerations regarding your son's condition:
1. Dietary Factors: A child's diet can significantly impact their bowel movements. If your son has been consuming a diet low in fiber or high in processed foods, this could lead to softer stools or diarrhea. Ensuring he has a balanced diet rich in fruits, vegetables, and whole grains can help promote regular bowel movements and improve stool consistency.

2. Hydration: Adequate fluid intake is crucial for maintaining healthy bowel function. If your son is not drinking enough water, this could lead to constipation, which may cause overflow incontinence, where liquid stool leaks around hard stool in the rectum. Encouraging him to drink plenty of fluids throughout the day can help.

3. Constipation and Overflow: The symptoms you describe may suggest that your son is experiencing constipation, which can lead to overflow diarrhea. When a child is constipated, the stool can become hard and difficult to pass. If the rectum is filled with hard stool, liquid stool may leak around it, causing the wetness you observed. This could explain why he feels the need to have a bowel movement when he experiences this wetness.

4. Infections or Gastrointestinal Disorders: While less likely, it is also important to consider the possibility of gastrointestinal infections or other underlying conditions that could cause changes in bowel habits. If your son has had any recent illnesses, changes in appetite, or other symptoms such as fever, it would be wise to consult a pediatrician.

5. When to Seek Medical Attention: Given that your son has experienced this issue multiple times over the past few months, it would be advisable to consult with a pediatric gastroenterologist. They can perform a thorough evaluation, including a detailed history and possibly some tests, to rule out any underlying conditions. It is particularly important to seek medical advice if your son experiences any additional symptoms, such as abdominal pain, blood in the stool, or significant changes in appetite or weight.

In conclusion, while occasional changes in bowel habits can be normal in children, the frequency and nature of your son's symptoms warrant further investigation. A pediatric gastroenterologist will be able to provide a comprehensive assessment and recommend appropriate management strategies tailored to your son's needs. In the meantime, focusing on a balanced diet, adequate hydration, and regular bathroom habits can be beneficial. Thank you for reaching out, and I hope your son feels better soon!

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