“If a preschooler truly has not had a BM for three weeks, I would be concerned and seek medical care immediately,” says Joel Gator Warsh, MD, of Integrative Pediatrics and Medicine, Studio City, CA, and part of the pediatric staff of Cedars-Sinai Hospital.
Many parents believe that when a preschooler or older child goes for many days without having a bowel movement, it’s a behavioral issue.
Go ahead, try withholding your poops for longer than three days, let alone a few weeks. Impossible. So why would a child be able to pull this off?
“You should be seeking care after five days with no bowel movement,” says Dr. Warsh.
“A child can withhold stool for a few days, but three weeks would be an extremely long time to hold in stool, and I would be worried about the child’s health.
“I would not be thinking this is withholding at that point and would be broadening my differential diagnosis. This child needs an abdominal X-ray and workup.”
Preschooler Not Having BM in 3 Weeks
Indicates a Medical Problem
“I would be concerned about an intestinal obstruction,” says Dr. Warsh. “Did your child have a surgery before? Were they in the NICU? Are they having abdominal pain or distention?
“Adhesions can develop causing a stenosis [narrowing] in the gut, leading to partial or full obstruction.
“If stool continues to build, this child would be at risk for intestinal perforation” which is life-threatening. “They may need to have manual dis-impaction or a GI scope.”
Maybe It Only Seems that
Your Preschooler Hasn’t Pooped
in Three Weeks
Dr. Warsh explains, “Something else to consider would be an inaccurate history provided by the parent. Maybe the child has had some small stools.
“Maybe the preschooler had some stools they were not aware of. That is something to consider, but after three weeks, I would be very worried and want the child to be evaluated by a GI specialist immediately.”