Best Way to Detect Bowel Problems and Hemorrhoids in a Child

If your child has a bowel problem, especially constipation, it is possible that you are not aware of it. As is the case with many parents who do not wish to become unhealthily preoccupied with their children’s bowel movement routines, you may have simply not noticed. Or your child’s urinary problem may have drawn your attention away from it.

Does Your Child Have Constipation or Encopresis?

How do you know when your child has a bowel problem? You need to be able to answer these questions:

• Does your child have a bowel movement each day, or does he fre­quently skip one or more days?
• Does the bowel movement come easily, or does your child strain to move his bowels?
• Is there pain with a bowel movement?
• Does your child complain of “tummy aches”?
• Does your child stain or soil his underpants with stool?

You should suspect a bowel problem if your child does not have a bowel movement each day, strains to pass his stool, complains of belly aches, or soils his underpants with stool. (If your child’s underpants are stained with stool, this staining is probably not the result of hasty wiping or improper hygiene, as many people think, but the result of abnormal stool consistency or abnormal anal canal function.)

Some children suffer alternately with constipation and encopresis; their stools are too solid and difficult to pass for a time, and then loose, watery stools make their way around the blockage and pass involun­tarily. This alternating pattern is true of most (although not all) children who experience encopresis.

In questioning your child about bowel problems, be sure to explain that you need this important information for the doctor. Make your child a partner in the detecting process.

Does Your Child Empty Her Bowels Incompletely?

Sometimes children move their bowels daily, but only partially empty the rectum, a condition that can also cause bedwetting. If you wish to check for partial emptying yourself, you can wait until just after your child completes a bowel movement and then insert a pediatric (child-size) glycerine suppository into her rectum. If the suppository causes her to produce more feces at this time, then emptying has been incom­plete. Before performing this procedure, of course, be sure to explain gently to your child what the procedure will tell you and why it is nec­essary to know this.

If you find that your child’s bowels are not emptying completely, you should tell this to the doctor. If you do not feel comfortable about subjecting your child to a suppository, you can ask the doctor to conduct an examination by ultra­sound. This method is not invasive, and it would be less stressful for both you and your child.

Does Your Child Have Hemorrhoids?

If the stool remains too long in your child’s rectum it hardens, and when your child finally passes such a stool, it can cause anal canal irritation or a painful split (fissure) in the delicate anal lining. Fearing pain, your child may delay passing stool. The cycle is repeated again and again: hard stools, anal irritation or fissure, and delayed movement. Hemor­rhoids, a result of this cycle and of straining to pass the hardened or overly large stool, occur more frequently among children than most physicians suspect.

Hemorrhoids can occur externally (at the anal opening) or inter­nally (inside the anus). You yourself can easily see any external hemor­rhoids, which are bluish, raised areas at the opening of the anal canal. (Be sure to explain gently to your child what you are looking for—and why it is important to know this information.)

You will not be able to detect internal hemorrhoids; even the phy­sician cannot detect them in an ordinary physical exam.