Your son’s inability to pass stool at four weeks old could be a sign of an underlying medical condition. An evaluation by his pediatrician is warranted for further workup.
A common cause of chronic constipation presenting early in life is an anal stricture. Strictures are a benign fibrous circumferential band of tissue that prevents the anal sphincter from dilating. Strictures are diagnosed on a physical exam. Surgery can be performed to release the stricture.
Hirschsprung’s disease is another common cause of chronic constipation. Hirschprung’s disease is a congenital disorder whereby nerve cells are absent in a segment of colon resulting in the inability of that segment to contract. This results in chronic constipation as stool is unable to pass through the affected segment. Hirschprung’s disease is diagnosed with anorectal manometry, barium enema, and biopsy of the affected segment. Surgery is then performed to remove the affected segment.
