Leaking Stool in
Underwear Esteban Soto
4-Year-Old with i-Human
Case Study
EXAM
, I. Case Overview
Patient: Esteban Soto, 4-year-old male.
Chief Complaint: "Leaking stool in his underwear".
Setting: Outpatient primary care clinic.
II. History of Present Illness (HPI)
Esteban is a 4-year-old male brought in by his mother for
recurrent stool leakage. The mother reports the onset occurred
approximately six months ago, with episodes gradually increasing
in frequency. He has a stooling pattern characterized by
infrequent bowel movements, occurring every 3-5 days. When he
does pass stool, it is described as large, hard, and painful, often
clogging the toilet.
The mother notes he exhibits stool-withholding behaviors, such
as crossing his legs, stiffening his body, or hiding in a corner when
he feels the urge to defecate due to fear of pain. The leakage is
described as soft or semi-formed stool that occurs daily, often
without the child's awareness. Episodes occur 1-3 times daily and
sometimes at night. There is no history of fever, vomiting, or
blood in the stool. Diet is low in fiber and high in constipating
foods, including whole milk (3-4 cups/day), rice, pasta, and
bananas.
III. Past Medical, Family, and Social History (PMH/FH/SH)
Past Medical History: Full-term birth with no complications;
passed meconium within 24 hours of birth; immunizations
are up-to-date; no chronic illnesses or surgeries.
Underwear Esteban Soto
4-Year-Old with i-Human
Case Study
EXAM
, I. Case Overview
Patient: Esteban Soto, 4-year-old male.
Chief Complaint: "Leaking stool in his underwear".
Setting: Outpatient primary care clinic.
II. History of Present Illness (HPI)
Esteban is a 4-year-old male brought in by his mother for
recurrent stool leakage. The mother reports the onset occurred
approximately six months ago, with episodes gradually increasing
in frequency. He has a stooling pattern characterized by
infrequent bowel movements, occurring every 3-5 days. When he
does pass stool, it is described as large, hard, and painful, often
clogging the toilet.
The mother notes he exhibits stool-withholding behaviors, such
as crossing his legs, stiffening his body, or hiding in a corner when
he feels the urge to defecate due to fear of pain. The leakage is
described as soft or semi-formed stool that occurs daily, often
without the child's awareness. Episodes occur 1-3 times daily and
sometimes at night. There is no history of fever, vomiting, or
blood in the stool. Diet is low in fiber and high in constipating
foods, including whole milk (3-4 cups/day), rice, pasta, and
bananas.
III. Past Medical, Family, and Social History (PMH/FH/SH)
Past Medical History: Full-term birth with no complications;
passed meconium within 24 hours of birth; immunizations
are up-to-date; no chronic illnesses or surgeries.
