Attempt: S.O. is a 4 year old male who presents to the office, with his father, complaining of leaking stool x3 weeks. His father reports hard, pebble-like stool x2 years with intermittent abdominal pain after eating. Father also reports patient’s bowel movements have been every 2-3 days and describes them as “hard balls.” Over the past 3 weeks, patient tells father “he can’t help it” and “it just comes out” regarding the recent watery stools. His dietary habits are poor with a diet of mostly chicken nuggets, crackers, and milk. Physical exam is significant for diffuse tenderness upon palpation of his abdomen.
Attempt: S.O. a 4 year old boy came into the office with father complaining of leaking stool into his underpants for 3 weeks. Father states he has intermittent abdominal pain after meals and hard stools for two years. Patient is potty trained and started loose stool episodes stating he can’t keep it in, it just comes out. Patient has bowel movements every 4-5 days looking like hard rocks. Patient has poor dietary habits with no water consumption and 4-5 cups of milk per day. Currently patient is going thru stress due to parents getting a divorced. Upon physical examination he presents with diffuse abdominal tenderness, no guarding or tenderness upon palpation and normal limits vital signs. Immunizations are up to date and no known allergies present.