, Patient Profile:
Name: Leo C.
Age: 4 years, 2 months
Sex: Male
Presenting Complaint: "He's soiling his underwear several times a day, and he has
very hard, painful bowel movements."
History of Present Illness:
Leo is brought to the pediatric clinic by his mother. She reports that for the past 6-8
months, Leo has been having increasingly difficult and infrequent bowel
movements. His stools are often described as hard, "pellet-like," or large and
painful to pass, occurring only 1-2 times per week. Approximately 3 months ago,
she began noticing frequent, foul-smelling stool staining in his underwear
(encopresis), which she initially attributed to poor wiping. The soiling occurs 2-4
times per day, often after meals or during active play. Leo seems unaware or
unfazed by the soiling at times. He strenuously avoids using the toilet for
defecation, hiding or doing a "potty dance" (crossing legs, squatting, redness in
face) when he feels the urge. There is no blood in the stool or underwear. His
appetite has decreased slightly, and he complains of intermittent abdominal pain
that is relieved after a large stool.
Past Medical History:
Birth History: Full-term, uncomplicated vaginal delivery.
Name: Leo C.
Age: 4 years, 2 months
Sex: Male
Presenting Complaint: "He's soiling his underwear several times a day, and he has
very hard, painful bowel movements."
History of Present Illness:
Leo is brought to the pediatric clinic by his mother. She reports that for the past 6-8
months, Leo has been having increasingly difficult and infrequent bowel
movements. His stools are often described as hard, "pellet-like," or large and
painful to pass, occurring only 1-2 times per week. Approximately 3 months ago,
she began noticing frequent, foul-smelling stool staining in his underwear
(encopresis), which she initially attributed to poor wiping. The soiling occurs 2-4
times per day, often after meals or during active play. Leo seems unaware or
unfazed by the soiling at times. He strenuously avoids using the toilet for
defecation, hiding or doing a "potty dance" (crossing legs, squatting, redness in
face) when he feels the urge. There is no blood in the stool or underwear. His
appetite has decreased slightly, and he complains of intermittent abdominal pain
that is relieved after a large stool.
Past Medical History:
Birth History: Full-term, uncomplicated vaginal delivery.
