2 1/2 year old girl very irritated bottom

[Melissakc]

My daughter has had an extremely irrated bottom since the first of feb.  She does have constitaption problems and began taking miralax daily in the middle of march.The constipation problem is now under control.   She has been to three regular peds. but after testing for an infection they all found none.  They said it had to be some irratate like soap, new detergent, some food she was eating.  To decribe what she has - The redness and swelling start in the front before her vigina, then her vigina and all the way past her anus. She is partly potty trained, but this problem seems to keep us from moving forward.  She seems to have a few days every couple of weeks that she seems to feel fine and there is no reddness.  Most days she is slightly sore and then about every two weeks she gets really bad.  When she has a dirty daiper it is changed immidately.  It seems to have no effect weather the poop has touched her or not, also is does start in the front area where the bowel movement does not touch. About the three or four of the times she complianes of her low back hurting. Lately she wants to sit on the potty for along time after she's done because she still needs to go.  She usually acts like it hurt or burns when she goes.  In general she is very fussy.  Her irration on her bottom is  HORRIBLE.
I wrote out everything she was eating to see if it was her foods. After comparing it I could find nothing that was doing this.   We've taken away dairy, and it did nothing.  I changed
her forom the large amounts of juice she was drinking to surgar free kolaids, crystal lite and tea.  It has done nothing.  I thought maybe she was having a problem with red dye, but the juice she had been drinking did not have it.  Since feb.  we have not used soap in the bathtub on her at all.  We wash her hair in the sink.  We have not changed our laundry deter. since she was 6 months old nor diaper creams and such.  She did get a Hep A shot in Dec.  Nothing else has changed.  Everyone acts like this is no big deal.  She hurting badly.  Please help!

Missy

[lmroswell]

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[Mary 53]

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[yoshi]

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[Kevin Pho, MD]

It is difficult to say without evaluation - and it is unlikely that I can come up with something after 3 pediatricians have already evaluated her.  

I think at this time a referral to a dermatologist would not be a bad idea.  A persistant fungal infection is certainly possible, and can be tested for via fungal cultures.  Treatment can be considered with a fungal cream.  

Allergy testing can also be considered if this is suspected.

This option can be discussed with your pediatrician or dermatologist.

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