6 yr. old son, many bowel issues

[rysmom]

My 6 yr. old son has had bowel probs even before potty training.  Horrible stench (like it had been festering for weeks)and large volume in diapers at 2, so-called withholding problems at 3-4 yrs, leakage and infrequent (1-2x/wk) BM's at 4-5 yrs.  Seeing ped gastroenterologist for past 9 mo's, sigmoidoscopy showed a healthy colon, but even after the pre-procedure laxative supposedly cleaned him out the scope showed he still had a lot of soft stool in the colon.  Takes GlycoLax daily until a week ago.  I took him off to see if there was any change in leakage or frequency, but it is the same off or on the med.  BMs now are so bulky and unformed, pudding-like, never hard, but fill the toilet.  How can he push out something so unformed?  It's almost like paste how it sticks to his bottom. For the past 2 months he's gone almost every day now but still having the leakage (daily) and urgency.  I'm concerned for the social aspect of school, he sometimes smells awful and needs to change his pants because of the leakage.  It's breaking my heart!  He's a sweet, lovable, beautiful boy and I honestly believe he doesn't know the leakage is happening until it's too late.  I can't believe the "encopresis" (sp?) issue because he doesn't have hard stools for the leaks to go around.  Sometimes it's more than just leaks, but actually very soft stool that squeezed out. I don't recall him ever having anything but soft stools, even as a baby.  They're almost too soft, but not diarrhea or watery. Just tonight (the reason for my panic post!) he was in the bathroom screaming about the stomach pain, which subsided after a very volumous, pudding-like BM.  It's almost as if he's producing too much.  Could it be a food issue?  I believe his diet is balanced, he's a good eater. He's otherwise healthy, normal weight and height, very active and social.  We go back to the ped gastro next week but I'm at a loss as to what to ask him.  He's been really great with my son, very sympathetic and easy to talk to about such a delicate subject.  He did mention at his first appointment that my son's rectum is stretched due to "withholding".  But withholding isn't the issue now.  He willing goes to the bathroom.  Please help!

[Kevin Pho, MD]

Difficult case - and I'm sure that these options have been considered by your gastroenterologist.  

Tests to consider would be abdominal imaging - including a plain film or CT scan.  Things like a rectal mass can be considered.  However, a normal sigmoidoscopy will make this possibility less likely.

Anorectal manometry can be considered to evaluate from Hirschprung's disease as well as anal spincter spasm - which
can result in the symptoms.

Blood tests checking the calcium levels as well as thyroid tests can also be done - abnormalities in these levels can lead to the symptoms.  

These options can be discussed with the gastroenterologist.
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.
http://www.straightfromthedoc.com

[MLWTR]

You might want to ask the pediatric gastroenterologist about the possibility of celiac disease. It can cause very bulky, very foul-smelling stool (due to malabsorption in the small intestine). This disease is initially ruled in or out using several blood tests to measure antibodies to gliadin (a protein found in wheat). If one or more of the blood test is positive, than an upper endoscopy is done to examine the villi of the small intestine (to see if they have the characteristic flattened appearance found in people with celiac disease).

Good luck finding a diagnosis. I hope your son feels better soon.

[yoshi]

what is his diet like??

[cmpaup]

My 6 year old son is still soiling his pants in school as well as home.  His bms seem similar to your son's.  We have tried everything also.  I don't want his peers to make fun of him because he smells.  I have tried GlycoLax also.  It doesn't make a difference.  He doesn't have fishers.  He makes every excuse up not to go both pee or poop.  We have to force him to go when we see it coming on.  He says that he doesn't feel it come out when it does.  He is in first grade and comes home smelling with a significant amount of bm in his underwear at least three times a week.  I think he has a slight form of autism and am getting a second opinion.  All I want is a solution to this.  He is too old to be doing this and like you, I am concerned about his health.  I don't want him to have problems later in life because of this.  Please tell me if you found any more help with this.  

Christina

[lspars]

I know that it is doubtful that you still check this post, but my son, too, has many similar symptoms.  As it has been more than a year, have you found any answers. I, too, am desperate, because my son is about to start kindergarten, and he is having three to four accidents a day, both urinary and bowel movements.

[dlhigh]

A friend of mine's son experienced the same symptoms and it took a few years to diagnose.  They finally determined that it was caused by drinking well water.  She was not aware that well water, especially if given to children under the age of two can cause this.  Medication is needed to be taken for a while to get rid of it.  If it's possible that a relative, babysitter ect. could have given your child well water then consult the GI about testing for this, I believe a type of parasite. Just another thing you can check for! Blessings for you and your little one.