Eight-year-old Waylan had a bad stomachache that would not go away.  His mother, Melanie, recalled, “He had horrible stomach pains, and he kept saying, ‘I need to see Dr. Hanaa.  Dr. Hanaa will fix me.’”

After some gentle questioning, Melanie suspected that Waylan’s discomfort was caused by constipation, and it was obvious that he needed medical evaluation.  She called the office of Pediatrician Hanaa Abdelmessih, M.D., and was able to schedule an appointment later that same day.

Dr. Abdelmessih has been Waylan’s pediatrician since he was born.  Melanie said, “He feels a special connection with her because she has always been there for him.  He had his first well-baby visit with Dr. Hanaa when he was just eight days old.  She has cared for him through all kinds of childhood illnesses, earaches and even a concussion.  She is really good with him.”

Waylan had been reluctant to tell his parents about his stomach pain, so Melanie was not sure that he would feel comfortable discussing his symptoms with a physician.  “I think his stomach had been hurting for three or four days before he told us,” Melanie said.  “By then his abdomen was very tender.”

After an examination, Dr. Abdelmessih confirmed Melanie’s conclusion that Waylan’s discomfort was caused by chronic constipation.  “Dr. Hanaa is amazing,” Melanie said.  “She got down to Waylan’s level, eye-to-eye, and spoke directly to him.  She explained the problem and even drew a picture of a colon to help him understand.  She told him the factors that aid the digestive process and asked him to help her devise a plan for his treatment.  She spoke in a way that made sense to him and did not embarrass him at all.”

Waylan’s personalized plan included medication, dietary changes and increased hydration.  “Every time that my husband or I had suggested foods with more fiber, Waylan resisted because it was just another thing that someone was telling him he had to do,” Melanie said.  “But Dr. Hanaa explained what was happening and then included his input in formulating a plan with specific tasks.  Because he was involved in the plan, he was excited about getting started.  As soon as we got home, he told his grandparents and his little sister all about it.”

Dr. Abdelmessih prescribed an over-the-counter laxative to soften Waylan’s stools and help him regain regularity quickly.  Then she and Waylan outlined the steps that would prevent future stomachaches. 

“One of Waylan’s tasks was to increase his consumption of fruits and vegetables,” Dr. Abdelmessih said.  “He told me that he already enjoyed lots of fruit, but was not fond of most vegetables.  However, he said that he liked carrots.  I assured him that carrots are an excellent source of fiber and vitamins,  but it also is important to eat a variety of vegetables, and he suggested others that he would be willing to try.”

Melanie said that Waylan implemented his personalized plan immediately.  “He began adding different vegetables to his diet, including broccoli, cabbage and kale.  He has a water bottle with ounce markings, and he began filling it to track his intake and ensure that he was drinking at least 40 ounces each day.  We had learned that another contibuting factor to his problem was that he had been restricting liquids to avoid the need to use a public restroom.”

Dr. Abdelmessih explained that many boys and girls have fears about using public restrooms.  “It is a very common problem for kindergartners entering school for the first time, but it also affects children of all ages.  The child is often embarrassed or afraid to talk about the problem, but with some gentle, non-judgemental questions, we often can learn the cause.  The child may have been bullied in the restroom or may be shy about using the restrooms with others nearby.  Little boys may not be confident about using urinals, which are different than the bathroom facilities that they are accustomed to using at home.  If I can help the child openly discuss his or her concerns, we can start to work on a solution,” Dr. Abdelmessih said.

Some tips that Dr. Abdelmessih suggests to help relieve children’s anxiety regarding public restrooms include:

• Take the child on a “rehearsal” trip to a public restroom when it is not in use.              
• Demonstrate approriate hygiene and handwashing techniques.
• Encourage the child to pair up with a buddy who will stand outside the stall door (or the entrance door of a small restroom) to ensure no one walks in.
• Review the child’s school schedule and identify times for restroom breaks to avoid last-minute, urgent situations.