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Dr. Gupta
Dr. Gupta, Doctor (MD)
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Experience:  Vastly experienced MD Physician with 19 years of experience.
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My five-year-old son has rectal bleeding, mucus in his ...

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My five-year-old son has rectal bleeding, mucus in his stool, pain in his side, and is sometimes in excrutiating pain when having a bowel movement. He is also VERY hyper-active. He has had x-rays, a Meckles scan, and been treated for pinworms, all with negative results. Please help me find out what is wrong with him so that he can go to kindergarten as a normal, healthy boy.
Submitted: 9 years ago.
Category: Health
Expert:  Dr. Gupta replied 9 years ago.
Hi,
I am a pediatrician,
Does he have significnat constipation?
Any allergies?
regards
Dr. Gupta
Customer: replied 9 years ago.
Reply to Gaurav Gupta's Post: He has times of constipation, but then other times of diarrhea. He had a milk allergy as a baby, but has since outgrown. He does have seasonal allergies, though. I have been doing some internet research of my own, and have found this article on Dysentery that describes a lot of his symptoms. Here it is:

Dysentery

Dysentery is a serious condition affecting the large intestine. It is characterised by inflammation and ulceration of the bowel, a colic pain in the region of the abdomen and passing of liquid or semi-formed stools with mucus and blood. Chidden are more prone to this disease than adults.

The pathological condition of dysentery is caused by two organisms, protozoa and bacilli. The dysentery caused by former is generally known as amoebic dysentery and by latter as bacillary dysentery. An attack of amoebic dysentery is milder in comparison with bacillary dysentery. But while bacillary dysentery can respond quickly to treatment, amoebic dysentery does not, unless the patient is very careful.

Dysentery is prevalent all over the world, except in very cold countries. Places, where poor sanitary conditions prevail, are particularly affected. The disease is most common in late summer, and in hot, tropical climates.

Symptoms

Dysentery in children may be acute or chronic. The acute form is characterised by pain in the abdomen, diarrhoea and dysenteric motions. Yellowish white mucus and sometimes only blood from the intestinal ulcers is passed with stools. The evacuations are preceded by pain and tenesmus. The child feels a constant desire to evacuate his bowels, although there may be nothing to throw off except a little mucus and blood. There is a feeling of pain in the rectum and along the large intestine. With the advance of disease, the quantity of mucus and blood increases.

Occasionally, casts or shreads of skin-like mucous membrane, from small fragments to 12 inches or so, long and an inch wide, are seen to pass out with motions. Sometimes pus is also thrown out with motion and often the small of the stools becomes very foetid. All the digestive processes are upset and secretions are changed or stopped.

Chronic cases are after-effects of acute attacks. The child does not recover completely. Stool remains putrid and may contain blood, while diarrhoea and constipation may alternate, and general health is disturbed. In severe cases, the temperature may rise to 104 o to 105 o F . It may occasionally become subnormal also.

Causes

Dysentery is caused by either protozoa or bacilli. However, the germs develop in the colon as a result of petrefaction of excessive quantity of animal protein food, fried substances, too-spicy foods and hard-to-digest fatty substances. Thus dietary indiscretion and eating of excessive amounts of fresh food in hot weather or tropical climate results in indigestion of such foods. The other precipitant factors include debility, fatigue, chill, lowered vitality, intestinal disorders and over-crowed, poor sanitary conditions.

The incidence of amoebic dysentery is very high in areas devoid of proper sanitary facilities. The infection may occur due to contamination of water with human sewage containing amoebic cysts. Various foods may be contaminated by being fertilized with human sewage or by flies exposed to infection or by careless food handlers who have the disease. Children may infect themselves by playing in muck contaminated with amoebic cysts.

Bacillary desentery is caused by certain germs of the shigella group, of which there are several varieties. These oganisms are spread from one person to another by contact, as well as through contaminated food and water. The disease may also be spread by flies. It is common in younger children. The germs pass directly into the intestine, causing swelling and superficial ulcerations. The inflammation in severe cases may involve whole of the colon and also the lower part of the small bowel.


Thank you!
Expert:  Dr. Gupta replied 9 years ago.
Dear Jill,
Thanks for the info on dysentery Smile
Its not very often that you get educated by patients about common illnesses....
However I understand your anxiety and the need to discuss all the possibilities..
Dysentery is ceratinly possible in case like your son's , however a stool test would quite easily pick it up...
Also this is almost certainly treated with antibiotics before further investigations like a meckel's scan are planned.
If his weight gain is inadequate then I would be worried about the possibility of an Inflammatory Bowel disease which while uncommon in children can present with simialr symptoms...
Talk to you pedaitrician and consider a duodenal biopsy under endoscopy as needed, for confirmation of diagnosis,
Take care,

Please ACCEPT the reply (by pressing the GREEN accept button), and give a BONUS if it was useful. If you need more information, just let me know.
Regards
Dr. Gupta

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