Okay...my question deals with bowel movements...what is considered normal and abnormal in amount/size? My 11 yo son is afraid to go to the bathroom because his BMs are so large they actually hurt him.
Hello, and I'm sorry to hear your son is having painful BMs. Simply put, if it hurts to go, it's considered abnormal, especially if it happens consistently. I do have a couple of questions for you, however. Does your son have any history of constipation or trouble with his bowels? Has he ever seen any blood after a bowel movement? How often does he go and does he ever have any accidents?
Constipation is a common cause for hard, painful BMs, and many younger people end up afraid to go because of the pain. In such cases, my goal is to get the patient to have one soft, non painful BM each day. There are several ways to accomplish this goal. First, it's necessary to drink enough water during the day. Water will help keep the stools from drying out. The other thing that can help is eating the right kinds of high fiber foods, especially fruits and vegetables and bran. You should also avoid milk and cheese or other foods that can worsen constipation. Benefiber or miralax are fiber supplements that can be added to his diet to help soften stools.
If these things fail, there are medications which can be prescribed, but I would suggest seeing your physician to help you get on the right track. Generally these things will take some time to succeed, so you may have to give it a week or two to see results.
I hope that this answer helps, and please let me know if I can further clarify or answer any further questions.
He doesn't drink as much water as I would like him to, and that is one of the things I stress to everyone at home. He hasn't had any history of constipation and there has never been any blood afterwards either. I have been working with him as far as eating more fiber, also. When I say large movements, I mean really LARGE...as in as big around as his arm and sometimes as nearly long as his forearm...no exageration, I swear. Will more hydration and fiber help this?
Don't worry I believe you and have seen/heard very similar stories. No wonder it hurts him.
I definitely think that he's somewhat 'backed up' or constipated. Usually there's a lot that needs to come out, and when it does, it's large and painful. Many children learn that having a BM hurts, so they hold it, making the problem worse and backing them up further. It's often a cycle that perpetuates over time.
I do think that hydration and fiber are the places to start when this happens. The idea is that the fiber will eventually help push out everything that's in there, and enable him to have normal calibur BMs. He may need other laxatives in order to help, but often taking adequate fiber will do the trick. If the diagnosis is in doubt, some physicians obtain a plain x ray of the abdomen area which can show how far backed up the stool is, but this isn't always necessary.
I would start with Benefiber or Miralax and give it some time to work through his system. Take it consistently every day. If you feel that you're not getting anywhere, then a trip to your pediatrician may be necessary to further evaluate what's going on.
Pediatric hospitalist at a dedicated children's hospital
Thanks so much for your time. I really appreciate your getting back with me so quickly. I will try the fiber and keep harping on drinking more water :) You have been most helpful.
You're very welcome and good luck!