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How common is chronic constipation in young children really? / some wider problem?(37 Posts)
Dd3, aged 3 years, 8 months is terrified to poo. This has been going on now for about 18 months at least. She will use the toilet to wee, but given the choice will not poo at all. Movacol does absolutely nothing. When she needs to poo she goes to lie down on her front and holds her buttocks together until it goes away. The GP gives me suppositories which I have to put in which is the only thing that will result in the poo coming out. Then what follows is about 20 minutes of crying and screaming until she finally goes in a nappy. When she is going she looks terrified. I have tried endless things to reassure her - stories etc and will always help her and talk her through it when it's happening, saying it's normal etc.
I have taken her to the GP many, many times but they say there isn't anything they can do about it except prescribe movacol and suppositories and of course I do see that the problem is psychological anyway.
The GP said this problem is very common in her age group - is it though? I have started to worry because she is due to begin school this year. I have also started to note other things about her which cause me to wonder if she has some undiagnosed problem - ie she hates having her teeth cleaned or her hair brushed and she screams the house down unless she can leave with her dummy, blanket, bear and drink - which she has to hold all of. She also needs to be in control of everything and gets very stressed if she can't. Lately I have noticed she wanders about the house reciting scripts from television programmes - this concerns me! (my older dd with ASD did exactly this). I always thought dd3 was unlikely to be autistic as her first word was 'no', which she used properly and in context well before the age of 2.
Nursery were concerned about her language development last year but then over the summer holidays she progressed a lot and they are now happy with that. It was put down to the fact she has glue ear. When the HV tested her language it was found to be slightly above average.
I am not sure if she seems quite normal though. Any thoughts?
Definitely try lactulose (and prune juice as an alternative. Also making the loo a fun place (blowing bubbles can help!)
Also look at the ERIC website (they are very helpful
my advice would be focus on the phsyical affects before looking at ASD - even if she is ASD you still need to address her pooing and any sensory issues will be affected by that and her glue ear. How bad is the glue ear? Can she hear all the pooing strategies and reassurance?
Some good advice about seeing another GP for advice, good luck x
Firstly, you definitely should see a paediatric gastroenterologist.
Secondly, Movicol does work but what you're describing doesn't sound right for a child on Movicol. Your DD could have chronic faecal impaction which is never resolving itself. That would explain the leakage issues she has. Again, a gastro would be able to look into this and review the Movicol dosage accordingly.
Thirdly, yeah it is very common. My DD has been on Movicol since she was 7m.
Thank you all again. I am going to explore all possible angles, but one thing's for sure - this can't go on with no answers!
Hi perception, so sorry to hear about your dd, it is so distressing to see them like this (I have history of bowel problems with ds and have faced some very apathetic doctors ).
Have a look at the guidance page for HCPs regarding the management of chronic constipation here. It says that you need to continue the movicol for several weeks after normal bowel movements have been established but if they do not establish after 3 months then referral is necessary (NICE guidelines). Maybe you could print this page out and take it to your doctor to show him
and give him a kick up the backside for not doing his properly?
My ds has an appt on Monday for his ongoing bowel problems and I have said that I am not going to leave the hospital until something is done; sometimes you have to become a little more than assertive in order to get things moving.
Good luck and I hope your dd's condition is treated promptly.
Thank you so much, ItsOkay - that is very helpful. She has been on movacol for a long time - I found it doesn't seem to make the poo come out. At nursery they also said that in their experience it doesn't seem to help the children they have known to be on it.
Sadly that's what's happened to ds too. He's been on Senna in the evenings and Movicol in the mornings for almost a year now and still has problems . Lactulose and Movicol don't encourage the poo to move, they just soften it so that when you go, it isn't hard iyswim.
Has she had any other symptoms like mucus or blood mixed with her stools?
<disclaimer, i am NOT medically trained in this!>
No, no blood or anything. I have found that they best way to get it out is not to use movacol and to just use a suppository every few days. That way a very normal looking, large poo comes out. The problem is, of course that she doesn't like me putting it in and we can't go on like this really. I am not sure if she might need a scan to see what's inside?
As this has been going on for a lot longer than 3 months then I would say she does need an x-ray or scan to eliminate the chance of an obstruction somewhere.
It really could be that she has been constipated in the past and had a fissure/ piles which has/ have taken a long time to heal and created a cycle of stool witholding but I would insist on seeing a paed to make sure as GPs aren't specialists in this.
It's so incredibly frustrating when you know something isn't right with your child and yet the professionals look at you as some hysterical mother (sorry, having a vent here!).
Oh, I forgot to say that we were referred to the constipation clinic by the local paed and we were told that ds, who is now 23 months and has been constipated since 6 months (start of weaning), had toddlers' diarrhoea, HE"S NEVER HAD DIARRHOEA! We are now getting him tested for hirschsprung's disease as apparently it might be that after all
OP she sounds so similar to my friends DS who also recites scripts and uses lines from books in context instead of coming up with his own thoughts and impressions.
He zones out too and hasn't yet referred to her as Mummy or Mama....he talks but it's all from books and tv or songs he's learned. He doesn't ever ask for anything and as a result she just keeps drinks to hand and offers regular snack.s
He can't ever comment on things off his own bat...so if it's dark then he'll say something from the Gruffalo about the deep dark wood....he also has chronic constipation.....but he does have some good eye contact and social smiles...no pointing....he plays beside others.
He's on lactulose but it doesn't really help and my friend is worried but wants to see how he progresses as he's just about to turn 3 in Spring. I will tell her to do as you've been advised with the list.
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