dyschezia, straining with stools

Dyschezia refers to excessive straining with stools, specifically referring to a very common problem of newborns, and perhaps more subtle difficulties with toddlers being toilet trained.

Babies often seem to make quite a production out of a bowel movement, and sometimes even seem to be in pain as they strain and push. This is often labeled "constipation" by parents, but is technically not true constipation. True constipation refers to infrequent, hard stools - straining in and of itself does not necessarily mean constipation.

"Dyschezia" is really a fancy term for uncoordinated pooping. Simply put, babies sometimes seem to have to figure out how to pull their legs up to relax the pelvic floor and let the stool come out. They may kick out with the legs held straight while straining; this is guaranteed to prevent the bowel movement from proceeding normally. Baby pushes with the abdominal muscles and especially the diaphragm (by grunting) and appears to be in great discomfort.

For short term relief it is OK to use a glycerine enema^* or to stimulate the anus with a lubricated rectal thermometer, but the best and permanent solution is to help your baby learn to relax and release the stool.

You do this by holding her knees up towards her stomach (as if she were squatting) while she pushes. She will get the hang of it soon. It might be a good idea to run your baby by your doctor's office and he can do a quick little rectal exam on her - this rules out any sort of rectal obstruction while stretching the anus a bit, making stooling easier for her.

When your toddler attempts to learn to have a bowel movement on the potty, it is important to provide something - a footstool perhaps - for him to put his feet upon so that they are elevated enough to make the proper "squatting" position possible. Otherwise the same difficulty with straining can arise, leading to difficulty with toilet learning for BM's. For this reason I think potty chairs - low to the ground and portable to take with you - are a good idea. See also a related article on infant constipation.

* Babylax®, which I prefer over suppositories for the simple reason that they work a lot more reliably. Glycerine whether by suppository or enema is simply a lubricant and cannot cause any sort of laxative dependence. Glycerine is actually a food product which is an ingredient in some candies.

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