### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi I am a mother of a 4.5 year old boy. My son has a problem with stool witholding for about four months now. He solis his pants with some stool from the 3 rd day from the last bm. He goes about every 8 days, or sometimes 6 or 7. He sits on the potty couple times a day it seems he will produce a stool, it smells, but the he witholds and the stool doesn t come out. I think he is afraid that it will hard him when he goes. He got constipated around august, hte stool was after 8 days, very hard and some blood on it. He had an infection of the throat then and didn t want to eat anything, so I gave him some chocolate desert he likes and some other things that made him constipated, because I was afraid he didn t want to eat and loose wait, not be able to fitght the infection. Since then he has been witholding the stool. I went to the peditrician, she said to take decoman and that didn t work so we tried lactulose, after that was no improvement in frequency and he had cramps and his behavior was different. He was irritated a lot. I look him of lactulose and I don t know what to do next. He had an ultrasound, but it didn t show anything specific. The doctor who preformed the ultrasound said that there is some fecal matter in the stool. Now doctor is saying he needs an x-ray with contrast or somethin. I would be thankfull for any advice. I don t know how to help my son, so he can go more often and the stools are not as hard. I give him prunes, otmeal, fresh apples and pears.. he doesn t eat nay chocolate or bannanas-nothing that will make him constipated more. Thank You for any advice.

### output:

This condition is brought on by fear of pain or through some psychological stress that the child has/had recently. In this condition, known as encopresis in technical language, the child voluntarily holds back his stool and because of the internal pressure, develops bloating of the stomach, pain, flatulence, and occasionally soiling with liquid fecal matter into his pants. Treatment must be under the guidance of a psychiatrist with experience in pediatrics. Laxatives and diet alone will not work. Please consult a psychologist first, and on their recommendation, a psychiatrist, before going in for contrast study as recommended by your pediatrician.