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Cause for troble gaining weight with trouble pooping.

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I have a 18 month old girl who has extreme trouble in pooling she has torn her bum on many many occasions. She is not constipated though as they are never hard. Since birth she has never had a brown poo it has always been yellow with a Sandy colour through it. Although the past week it has just been a Sandy colour. She is currently on cows milk and a normal diet. She weighs 9.9kg and has had trouble gaining weight at a steady rate

Category: Pediatrician

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Category: ICU/ Critical Care Specialist
 23 Doctors Online

Thank you for posting your query at DoctorSpring.com
Dear Parent,
I can understand your concerns and can empathise with your situation.
At 18 months, her weight of 9.9 kg would be definitely on the lower centimes (5th-10th to be precise). Hence, there is definitely a need to evaluate her for underlying cause. It would be helpful to know her birth weight as well as other weight records over the first year. Kindly furnish details of any other growth parameter that you may have checked (height/ length at various ages).
History of abnormal stools is a pointer towards underlying malabsorption states, in a child with failure to thrive. It would be important to describe the stool odour, consistency, stickiness and bulk. Also need to know if your child is anaemic/pale. Multiple diseases like Celiac disease, other malabsorption states can present like this. In order to get a detailed evaluation, I would recommend a personal visit to the nearest Pediatric gastro-enterologist.
The description 'torn her bum multiple times' could mean that she has developed an anal fissure or something similar. This needs to be confirmed on inspection of the perianal region as well. The treatment for anal fissure would be modification of diet as well as local anesthetics and SITZ bath.
Kindly visit your local pediatrician as soon as possible for further help.
Feel free to discuss further,
Regards
Dr. Saptharishi L G

Dr. Saptharishi L G
DM (Pediatric Critical Care)
MBBS, MD (Pediatrics), PGDCRL


Patient replied :

Her birth weight was 2.5kg 45 cm in height Jan 2013 4 weeks check 3.6kg March - august 2013 she stayed roughly at 6.6kg November 2013 8.3kg March 2014 9.3kg July 2014 9.9kg 7 cm in height
He stool can sometimes smell like wine, like there is alcohol in it. It is mostly toothpaste consistency it mainly comes out in one it two pieces a few cm long. If I'll it looks clay. She does not have anemia nor is pale. She also has eczema which I have managed to control .


Hello. Thank you for writing to us again.
Dear parent,
Thank you for providing me with the above information. It appears that the birth weight and length are on the lower side.
subsequent weight gain is also lesser than expected.
I would strongly recommend a visit to nearest pediatrician.
Regards
Dr Saptharishi


Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Experience: 
Senior Residency: DM,  Pediatric Critical Care, PGIMER

Residency: MD, Pediatrics, Postgraduate Medical Education & Research (PGIMER), Chandigarh, 2013

Internship: JIPMER, 2009

Medical School: MBBS, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, 2008
Dr. Saptharishi L G and 4 other Medical Specialists are ready to help you

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