Diagnose

The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. Depending on how old your child is, you might be asked questions such as:

• How old was your baby when he or she had their first stool?
• How often does your child have a bowel movement?
• Does your child complain of pain when having a bowel movement?
• Have you been trying to toilet train your toddler lately?
• What foods does your child eat?
• Have there been any stressful events in your child’s life lately?
• How often does your child poop in his or her pants?

Your child’s provider may also want to do some tests to see if there are any problems. These tests may include:

• Digital rectal examination (DRE). Your child’s provider puts a gloved, greased (lubricated) finger into your child’s rectum. The provider will feel for anything abnormal.
• Abdominal X-ray. This test checks how much stool is in the large intestine.
• Barium enema. This is an X-ray exam of the rectum, the large intestine, and the lower part of the small intestine. Your child will be given a metallic fluid called barium. Barium coats the organs so they can be seen on an X-ray. The barium is put into a tube and inserted into your child’s rectum as an enema. An X-ray of the belly will show if your child has any narrowed areas (strictures), blockages (obstructions), or other problems.
• Anorectal manometry. This test checks the strength of the muscles in the anus and the nerve reflexes. It also checks your child’s ability to sense that the rectum is full (rectal distension) and a bowel movement is needed. And it looks at how well the muscles work together during a bowel movement.
• Rectal biopsy. This test takes a sample of the cells in the rectum. They are checked under a microscope for any problems.
• Sigmoidoscopy. This test checks the inside of part of the large intestine. It helps to find out what is causing diarrhea, belly pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube (sigmoidoscope) is put into your child’s intestine through the rectum. This tube blows air into the intestine to make it swell. This makes it easier to see inside.
• Colorectal transit study. This test shows how well food moves through your child’s colon. The child swallows pills (capsules) filled with small markers that can be seen on an X-ray. The child eats a high-fiber diet for the next few days. X-rays will be taken 3 to 7 days after your child takes the pills. The X-rays will show how the pills moved through the colon.
• Colonoscopy. This test looks at the full length of the large intestine. It can help check for abnormal growths, red or swollen tissue, sores (ulcers), and bleeding. The test uses a long, flexible, lighted tube (colonoscope). The tube is put into your child’s rectum up into the colon. This tube lets the provider see the lining of the colon and take out a tissue sample (biopsy) to test it. The provider may also be able to treat some problems that are found.
• Lab testing. Several tests may be done. These include tests to check for issues such as celiac disease, urinary tract infection, thyroid  problems, metabolic problems, and blood lead level.