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Question: My 10-year-old grandson is pooping his pants all the time. He has seen a Dr. and his docter says he is constipated and the runny poop is a bypass. So the doctor put him on a speacial diet and laxative twice daily. But this doesn't work--he still poops his pants.The doctor feels his stomach and says he has solid stools. But no tests or x-rays have been done. Can you give some advice?

Answer: Stool soiling is commonly related to constipation and the child holding the stool for a long period of time, and stools leak out out because the bowel is too full. The reason for the child to hold the poop is multifactorial and most commonly the child does not like the pain that hard and large stools cause. The treatment is to make the stool soft and small to allow the bowel to squeeze the poop along. Dietary changes and laxatives are helpful. Abdominal x-rays are helpful to diagnose constipation. If conservative treatment fails, then a consultation with an expert in gastroenterology (GI specialist is necessary. Sometimes children with psychological issues can also have stool soiling and a psychological evaluation may be helpful. Other times they have urinating issues and a pediatric urologist may be involved to help the children.

Answered on -- by Donald Nguyen, MD, pediatric urologist, Dayton Children's

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