It is important to come to your appointment prepared, with notes on your child’s symptoms as well as his recent diet and medications. It might even be helpful to keep a “poop chart” for a few weeks beforehand. You’ll probably be asked questions like:
- When did your child beginning experiencing symptoms?
- Does anything seem to improve or worsen his symptoms?
- Have his symptoms been continuous or occasional?
- Is there a family history of digestive problems?
- Does your child strain with bowel movements? Have you seen blood?
- Has there been any change in your child’s medications or dosages?
The physical exam will likely include placing a gloved finger into your child’s anus to check for abnormalities and the presence of impacted stool. Rarely more extensive testing might be conducted for severe cases, including:
- Barium enema X-ray
- Rectal biopsy (to determine if normal nerve cells are present)
- Anorectal manometry or motility test, where a catheter is placed in the rectum to measure the coordination of the muscles your child uses to pass stool
- Colonic manometry, which measures the contractions of large intestine and is done during a colonoscopy
- Transit study or marker study, in which your child will swallow a capsule containing markers that show up on X-rays taken over several days to see how they move through your child’s body
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