i human

1. Discuss the each of the following possible causes of a child with chronic constipation and the tests/labs needed to rule the diagnosis in or out.
2. Constipation present since birth or early infancy.
3. Persistently narrow diameter stools.
4. Failure to gain weight/weight loss.
5. Abdominal distention.
6. Include the following components:
7. write 150-300 words in a Microsoft Word document
8. demonstrate clinical judgment appropriate to the virtual patient scenario

A 4-year-old male presents with his father for evaluation of stool leakage into his underwear for the past 3 weeks. The father reports a 2-year history of chronic constipation with bowel movements occurring every 45 days, described as small, hard, rock-like stools. The patient experiences intermittent abdominal pain, often after meals. He is fully potty trained but recently developed episodes of loose stool, stating he cant keep it in and that it just comes out. There is no history of fever, vomiting, blood in stool, weight loss, or delayed passage of meconium. Dietary history is significant for no water intake and consumption of approximately 45 cups of milk daily. The patient is currently experiencing psychosocial stress related to his parents ongoing divorce.