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Dr. P. Jyoti
Dr. P. Jyoti, Consultant MD
Category: Medical
Satisfied Customers: 9126
Experience:  17 yrs experience in treating OPD & Emergency patients.
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Could this be hernia?

Resolved Question:

This is regarding my five year old son who has never suffered any bowel issues in the past. About 7-8 weeks ago before school one morning, he began going to the toilet around 10 times, each time passing bowel motions. So I initially thought it might be a nervous stomach. But then it began to progress to him going around 10 times when he came home as well and when I dropped him off at school I would have to leave him on the toilet.  Our whole life seemed to revolve of him hopping on and off the toilet.


 


After two weeks of this not easing up, I took him to the doctors who thought it might be constipation. He advised a disimpaction routine with Movical, 8 sachets a day. So eventually we got to the point of pooing brown water. We moved him down to the maintenance dose and he started to be unable to go to the toilet again. Was again advised to restart the disimpaction routine as maybe he hadn't done it for long enough. Again, he pooed brown water. The main thing that is concerning me is that he is complaining of groin pain. When I took him to the doctors last I asked him to check him over and  he said he could see an inguinal bulge when he coughed, but assured me it was nothing to worry about. The advice was to just give him lots of sympathy. Now we are back down to four doses of Movicol a day and he is passing pea-sized amounts of poo again. I asked if he could have a scan for the groin pain, but was told there wasn't such a thing. What would you suggest?

Submitted: 3 years ago.
Category: Medical
Expert:  Dr. P. Jyoti replied 3 years ago.

Dr. P. Jyoti :

I am Dr. P. Jyoti, MD. I promise to use my full experience and knowledge to provide answers specific to your question. Feel free to ask me anything.

Dr. P. Jyoti :

hello has he had any tests done?

Customer:

No, he hasn't had any tests done. I wish they would though.

Dr. P. Jyoti :

thats right

Dr. P. Jyoti :

there are a number of conditions that need to be ruled out

Dr. P. Jyoti :

i see you are typing, i will wait for your message

Dr. P. Jyoti :

its no use if we both type at the same time or we will just be cross chatting

Customer:

I was just going to add he had an umbillicial hernia when he was a baby, although I am not sure if that is of any relevance to now.

Dr. P. Jyoti :

ok

Dr. P. Jyoti :

i will complete my answer now, please hold on till i complete it

Dr. P. Jyoti :

you may then ask any questions that you have

Dr. P. Jyoti :

the umbilical hernia is not significant here

Dr. P. Jyoti :

but there are a number of possibilities

Dr. P. Jyoti :

stool impaction is one possiblity as your doctor suggested

Dr. P. Jyoti :

but with the medicines he has ben taking this would be more or less ruled out

Dr. P. Jyoti :

there are other possibilities that need to be ruled out

Dr. P. Jyoti :

Infections: Viral or bacterial infections can cause this. Viral infections would usually not last this long. Organisms which can cause such prolonged diarrhoea are C. difficile, and protozoa such as giardiasis. A stool examination is necessary to detect the cause of the infection. You should ask your doctors whether these have been tested for.

Dr. P. Jyoti :

Malabsorption: malabsorption syndromes like coeliac disease may cause this.

Dr. P. Jyoti :

gluten enteropathy - a sensitivity to gluten in wheat products

Dr. P. Jyoti :

Inflammatory bowel disease: This includes Crohn's disease and Ulcerative colitis. Various tests including biopsy may be needed to establish this.

Dr. P. Jyoti :

Diverticular disease: diseases of the intestine like diverticular disease may cause chronic diarrhoea.

Dr. P. Jyoti :

the first three are more important for a child

Dr. P. Jyoti :

note down these causes and ask your doctor about them

Dr. P. Jyoti :

tests should be done for this and these conditions should be ruled out

Dr. P. Jyoti :

it is important to have these ruled out

Dr. P. Jyoti :

by noting them down you will be able to get a better informed discussion from your doctor

Dr. P. Jyoti :

hope this leads to a solution for him

Dr. P. Jyoti :

take care

Dr. P. Jyoti :

any further questions?

Dr. P. Jyoti :

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Dr. P. Jyoti

Dr. P. Jyoti :

do you have any further questions?

Customer:

Yes, my main worry is that he has a hernia. If my son is experiencing groin pain and the doctor saw that he has an inguinal bulge on the side he is complaining, do you think more tests should be done on that?

Dr. P. Jyoti :

well inguinal hernia is more of a clinical diagnosis

Dr. P. Jyoti :

if the hernia is big to the point that it can cause diarrhea or any other intestinal symptoms it would be quite obvious clinically

Dr. P. Jyoti :

the doctor would not miss it

Dr. P. Jyoti :

no tests as such are required for diagnosing an inguinal hernia, it can be done clinically

Dr. P. Jyoti :

i do not think there is inguinal hernia as it would be diagnosed clinically

Dr. P. Jyoti :

but of course discuss this with your doctor also

Customer:

Ok thank you, XXXXX XXXXX my main concern is that he has noted a bulge in that area. Hopefully this will be my last question, but is it possible to get a bulge there then whilst coughing if no hernia is present?

Dr. P. Jyoti :

in children sometimes the muscles are a bit weak

Dr. P. Jyoti :

a bulge may be a precursor of a hernia, but usually it will not progress to a full hernia

Dr. P. Jyoti :

as the muscles strengthen the bulge will disappear

Dr. P. Jyoti :

inguinal hernias are usually congenital in children

Dr. P. Jyoti :

it would havebeen diagnosed at the time of theumbilical hernia

Dr. P. Jyoti :

in this case i do not think it is an acutal hernia

Dr. P. Jyoti :

but ask your doctor also

Dr. P. Jyoti :

You now need to give a rating if the answer has satisfied you and you have no more questions.
We are paid only when a positive rating is given.
Thanks.

Customer:

So would you advise taking him back on Monday then to the GP?

Dr. P. Jyoti :

yes thats right

Dr. P. Jyoti :

go back to the GP

Dr. P. Jyoti :

ask about the conditions I mentioned and discuss them

Dr. P. Jyoti :

not of course that they are all likely

Dr. P. Jyoti :

but discussing them will help get you an informed opinion

Customer:

OK thanks ever so much for your help. I will note down what you have suggested. Have a good day.

Dr. P. Jyoti :

also doctors also sometimes need a bit of prodding to takea case seriously!

Dr. P. Jyoti :

glad to help

Dr. P. Jyoti :

i am sure it will work out

Dr. P. Jyoti :

take care

Dr. P. Jyoti :

You now need to give a rating if the answer has satisfied you and you have no more questions.
We are paid only when a positive rating is given.
Thanks.

Customer:

Ok thanks - will do now. Bye xx

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