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Children's Health

White stool and constant abdominal pain......

03/02/2001

Question:

My 5 year old daughter has had chronic constipation since birth. Never was a constant pain complaint problem except during bowel movement. For 2 weeks now she has complained with constant stomach pain, wants to eat to stop the pain but only can assume a very small amount. I have tried to moniter her movements and today I witnessed her having a solid white bowel movement. I took her to our pediatrician wanting them to do a stool culture and concerned what was wrong, They wrote it off to gas, prescribed Metamucil...with no thourough exam. Why could a stool be white and I don`t think gas is causing her to hurt and persue these eating habits 24 /7. Please help!!! Thanks, Desperate MOM

Answer:

A normal color for bowel movements can vary quite a bit from pale yellow to dark green. Generally abnormal is considered gray or clay colored stools, and pitch black and tarry stools. Children with a very fast transit time (the time between when they eat and when they stool out that intake) may have stool that is relatively undigested. Mucus which is produced in the colon and rectum can appear light, but it is soft and resembles phlegm, not stool. Occasionally, a ball of stool may be coated with mucus and appear yellow-white. When it is submerged in water, the mucus will begin to disintegrate.

A truly light stool (all the way through) may indicate problems with the liver or biliary system, since it is the bile that colors the stool brown and green. This is less likely if a child is growing normally, however. In this case, the liver tests are usually abnormal on blood work, and the liver may feel abnormal to the examiner. Pain associated with liver disease is usually in the upper right portion of the abdomen.

Constipation itself is defined as hard bowel movements. We have answered many questions regarding constipation, and if you search our answers under this term you will find many of them. We try to change the diet so that the stools are soft, even if they are quite voluminous.

If a child becomes very constipated, he/she may experience obstruction, and be unable to hold down food. This requires an urgent evaluation by a health care worker. This can be a painful experience as well. Passing a large hard stool can also cause significant pain, and that is another reason to try and soften the stools.

Lastly, the presence of upper abdominal pain that improves with food is sometimes a symptom of acid stomach, and worst case scenario, an ulcer. An ulcer would be extremely unusual in a five year old child.

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Response by:

Caroline Mueller, MD
Assistant Professor
College of Medicine
University of Cincinnati