Time to get on the potty: Are constipation and stool toileting refusal causing delayed toilet training?

Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...

After spending 3 to 10 hours in the large intestine, chyme loses a lot of water and becomes feces, the final product of digestion. Feces consist of undigested dietary fiber such as cellulose, mucus, sloughed-off epithelial cells, and microbes. The descending and sigmoid colon stores feces and uses haustral contractions to dry it out but retains enough water to give it a semi-solid texture.
The mass peristalsis then pushes the feces into the rectum, which stretches the rectal walls to activate...

Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...

Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...

Laxatives are primarily used to alleviate constipation, a common gastrointestinal disorder characterized by infrequent bowel movements and difficulty passing stools. They work by various mechanisms to increase the volume or frequency of bowel movements. The primary modes of action of laxatives include increasing stool bulk, softening the stool, stimulating intestinal motility, and osmotically drawing water into the intestines.
Osmotic or saline laxatives, like magnesium hydroxide or milk of...

Sigmund Freud's psychosexual theory of development suggests that early childhood experiences significantly shape personality and behavior. Freud proposed that development is discontinuous, occurring in five distinct stages, each defined by a focus on different erogenous zones. He believed that failure to resolve the conflicts specific to each stage successfully could result in fixation, potentially influencing behavior as adults.
The Five Stages of Psychosexual Development
Freud's psychosexual...