Chronic constipation can be so uncomfortable in children. Further evaluation can be considered to ensure there isn't any underlying GI disease leading to the constipation.
This can include a barium enema, anorectal manometry, or colonic transit studies.
Diseases associated with chronic constipation can include Hirschprung's disease, lead poisoning, thyroid disorders, or Cow's milk intolerance.
These disorders should be evaluated for by your nephew's pediatrician.
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