Major complaints of stomach pain in 4 yr old who has distended belly

My almost 4 year old who rarely goes #2 is constantly complaining of stomach pain. For at least two weeks he says his tummy hurts.  Last nite woke up in middle of nite in terrible pain.  He tries to keep #2 in side but yesterday we had given him a suppository in the am so he was clear of poo.  Could this be appendisitis (appendicitis)? Some other serious problem other than anxiety over potty training/poo control issues.  He has severe anxiety over the thought of #2 we would love to alleviate his stress on this matter.  His tummy often looks funny (distended)  After eliminating yesterday in the am, he ate well, lots of fruit, two peanut butter and jellies on high fiber bread(we always eat the hf bread), piece of pizza.  We have an appt with our pediatrician tomorrow but he is older and I worry may be out of touch.  He recommends mineral oil.  We have given glycolax too.  The boy holds the poo in and when it finally comes out it is gooey not solid.  Any advice or guidance to share with our md would be terrific.
Thank you.
I have started a food and elimination journal just yesterday.
We have given suppository of baby lax at least 5 times in the past 2 monthes.  We believe he is trying to outsmart system and hold in the poop.  But the severy upset last nite was unsettling.
Once we give the suppository, severe anxiety develops from the feelings of the poo about to come out.(we believe)

[Kevin Pho, MD]

If there is a concern about appendicitis, a CT scan can be considered to rule that out.  

There can be many causes of constipation in children.  This can include thryoid disease, anatomical abnormalities, lead poisoning, Hirschprung disease, or cow's milk intolerance amongst others.

Tests to consider would be blood tests to evaluate for metabolic causes - including blood count, lead level, thyroid tests and a metabolic panel.  A barium enema can be done to evaluate for anatomical causes.  More specialized testing can include anorectal manometry or colonic transit studies.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[Duchess47]

I have Gastroparesis.  I don't know a lot about it in toddlers, but it means slow stomach emptying.  Symptoms are, nausea, constipation, stomach pain, stomach bloating.  Fiber is the worst thing for it as is, sugar and fat.  It may also be celiac disease which means no wheat products should be eaten.  At any rate, don't try to diagnose this yourself, see a pediatric specialsit.

[Kalio1]

When my son was a toddler he had some of the same issues. He would "hold it" because it hurt to go, making it worse and increasing his constipation.
see the doc because our doc gave him Colace, we put it in his bottle or juice and it straightened him right out and he eventually got over his poo anxiety because it didn't hurt to go. It took quite awhile as I recall but it did work. His tummy would be distended too.
I think it is a pretty common situation, at least my pediatrician thought so.
good luck

[brenda999]

I don't want to scare you but read my post about TRANSVERSE COLON VOLVULUS.  I am sure your son's is not the exact same situation, but just be careful. Also I would recommend that you have DR. do an exray, to see if colon is enlarged.  Thats how they caught my son's volvulus.  It is possible that the intestines/colon can twist and then untwist which is why they can have intense pain and then it goes away.  My son is still going through this. Dr's dont know what is causing his colon to become redundant.  He has had another portion of his colon stretch out since the last time he had surgery 6 months ago.Good luck. Let us know what you find out!  Maybe we can be of help to each other.

[parttime]

I have a 4 year old that had the same problem and they put him on Mirlalax for 2 months.  In the beginning we gave him the dose every day once he started going to the bathroom, we reduced the does.  When we took him to the MD he could feel that he was full of poo.  Just becuase they go once with a suppository there is still a lot more ahead..it can get impacted and be painful.  It needs to be soften before trying to have him push it out.
As well my friend had a 4 year old who complained and he had an aneurysym in his colon.  So be sure to mark what works and what doesn't.

[savywade]

Thanks all for your input re my almost 4 year old.  We went to the Dr today and he said he couldn't feel impaction and thought overall he looked good.  My Md thinks it is the anxiety.  He recommends the miralax and mineral oil.  We have been using the miralx and it does soften it but we have to still use the suppository after a while cause it won't come out.
I do appreciate all of your input

[Jinglebell]

Read up all you can on Celiac disease.  It is an auto-immune response caused by Gluten (found in wheat, barley, rye and a few other grains).  Rice is the safest starch to eat, but corn and potato are other safe sources.  Who would think a piece of bread could do so much damage to your stomach?  I know, I am a celiac myself.  Woman's Day magazine has published articles.
                   Goodluck, Jinglebell

[myproblem]

This doesn't sound like celiac to me, but it doesn't hurt to look into all possibilities. Mineral oil does sound like a good idea.

[lixychick]

I have several friends who have had this problem with their children.

After determining that this isn't a medical condition, which you have done...the more OTC medicine and "good for you" foods you present to your child, the more abdominal pain and fear of release will ensue!!!

Elimination for an adult is a common thing. Elimination for a child about to be potty trained is ASTRONOMICAL! Till you make them realize that what they have done in their diaper for all these years (whether remembered or as an infant)is not how they'll always do it as they grow older...it's ALWAYS been their creation and has never been flushed down a toilet immediately after they made it! The fear comes from taking away a part of the child that he feels he/she feels they don't want to let go of. Call it a power struggle...but the child has control of this which comes from his/her body, and you can't help by making up stories about what becomes of elimination and why they have to let it go.

Imagine this: You strain and struggle to produce your best work (whatever that work may be for you)...and someone with more authority than you comes along and says, "Good job...now I'm gonna dispose of it"! That sends a double message to do good but it's not worth keeping.

Instead, what I've seen work better at potty training is to explain that, "We eat the good things AND the not so good things and our body is so smart that it determines the good and keeps it and expels (eliminates, gets rid of) the not so good by way of poo and pee" <---or however you'd explain it best to your particular child. You'd be surprised how well a 4 year old can wrap his/her brain around that explaination. I know their is a child level book out there that explains potty training and why and where it all goes in terms children can grasp...I just don't remember the name or author.

Gotta admit...I'm surprised at all the advice to give OTC or prescription drugs before even considering that the child might just want to keep what is his/hers! Scares me to think of all the misdiagnosed circumstances in this day and age!!!

Hope this helps...and good luck!

[yoshi]

There was a thread may be a year or two ago of a child who did not want to poo,she tried to hold on to it as long as she can as passing the poo is painful to her.
I am not a child,but I have a mild case of lactose intolerance when i was younger,these days,I found out I cannot tolerate milk protein,it seems to stay in my lower abdomin (abdomen),close to the groin area and expand??and I would become constipated.
I read that there are kids/adults out there who cant digest milk protein,some cant even digest soy protein.
You should vary his diet and see what is affecting him-milk,high fibre bread,juice,other dairy product .oh,peanut butter ,check that out

[melala]

my 10 year old daughter has been complaining for several years about her stomach hurting...when she began school she would throw up a little after lunch several times a week.  we started monitoring her diet and tried to see is there was a common denominator.  we didn't really see one...after years of taking her back and forth to the doctors with a "stomachache" a new doctor decided have and xray taken and ran a battery of test including celiac disease, crones and food allergies just to name a few...she has always been sensitive to beef, fatty foods, as well dairy products(especially milk) but alas no food allergies.  she does experience pain when the doctor touches her stomach and that concerned the doctor so now we have an appointment with a gastroenterologist in july...any suggestions on what this could possibly be, any info. i can read before we go?  i want to have some idea of what this may be and/or what to expect when we go...my daughter is very healthy and we have a well balanced, nutritional and healty life style.  any help would be greatly appreciated.

[mskujo]

I would request an xray and upper gi to rule out gastroparesis.