Poo withholding - please tell me your happy endings(38 Posts)
So I'm in tears for the umpteenth time. DS has been withholding since June last year (at which point he was two and a half). I've tried every tip ever posted on mumsnet but nothing seems to work - prune juice, blowing up balloons, blowing bubbles, swimming, treats, senokot, lactulose, loads of fruit - you name it, I've tried it.
Just before xmas things seemed to get a little better - still holding but doing a plum-size poo in his nappy most days. A few weeks ago he woke up and announced "I want to wear pants to nursery" and because withholding is all about control I went with it. Apart from the first day he's had no wee accidents, but now the poo withholding has ramped up a gear. We've told him he can poo in pull-ups but he says he doesn't want to but won't go on toilet either. The last two days he's had a meltdown at the mere suggestion of pull-ups and is now running around wimpering.
Is Movicol the answer? Please tell me how you got through this and it will end eventually (read a horror story on here earlier of a child who was still this at 13!)
My DS1 has been on movicol for several years now. I honestly don't know how long he will need to be on it, but it has been a lifesaver for him! Nothing else worked! I think his longest hold was 18 days the GP told me that he felt my DS1 had a small fissure which meant it hurt to poo and so he began a with holding cycle! I'm not sure I entirely agree, I always felt that he behaved like he had piles and was aways told that small children don't get piles! Guess what?? DS2 has piles in spite of a very healthy diet with plenty of fruit and veg....
Either way! Go for the movicol, but if it turns to diarrhoea drop the amount, going the other way can be horrendous too! Good luck!
^what she said
The first few days of it kicking in are grim.... My gp described it as 'the inspiration for the chocolate river in Charlie and the chocolate factory' [eww]
Once they're only producing a normal amount of poo on the higher dose you can try dropping the dose gradually until you hit the minimum dose that will keep them regular but you absolutely have to get through the floods of runny poo first.
parched be really careful about this: "The next couple of days he did lots of poos, but they started to get runny, so I dropped the dose down to two sachets".
This is just what you should NOT do. You need a few DAYS of runny poo to be sure they are really cleared out, otherwise you go back to leaky poo in the pants again which is really impacted poo leaking out around the impaction. I know its grim, but a week at home is often needed and expect mess. It will then gets better from there xx
Thought I'd post an update: they day after my last post, DH had to collect DS from nursery as he was so upset and in pain. It was day 5 of Movicol with no result, so DH sat him on the toilet and explained that his tummy was full of poo and that's why it hurt; the only way to stop it hurting was to push out the poo but he would stay with him and hold his hand. Eventually, he did one (though was very upset) to much jubilation, cheers and treats. The next couple of days he did lots of poos, but they started to get runny, so I dropped the dose down to two sachets.
First day back at nursery after the previous week's trauma and he did 4 poos in his pants and also a couple of wees. We were despondent that we were going backwards but I tried to keep some perspective and thought I'd rather have poos in pants than no poos at all. The next day we had a couple of poos in pants and a couple on the toilet and the next day, two poos in toilet and no dirty or wet pants.
His poos later in the day were getting a bit runny, so he now has one sachet in the morning and one in the evening and we seem to have reached a good level, with a couple of poos a day of good size and consistency and - most importantly - no fuss .
It's not been a magic fix in that he's still trying to hold in poo, or at least put off going to the toilet, but with some gentle reminders he does go and sit on the toilet and happily tell me a poo is coming. So far the doctor is only prescribing 30 sachets a time, so I'm having to go back every fortnight. If he thinks this'll be fixed in a couple of weeks, he's much mistaken! Hopefully he'll soon get sick of me and give me a bigger prescription. It's made such a difference, I'm determined not to be fobbed off.
Anyway, wanted to say thank you to everyone who posted with advice, and for anyone else going through this, don't be scared off by some of the horror stories about Movicol. Give it a try as it really can make all the difference.
Thk you Peach! Managed to get her to drink a whole sachet today in an Innocent Smoothie (Mango), after mixing initially with 63ml water. Result; first soft poo in days!! (Had success last week, but went backwards again Thur/Fri Sat/Sun). She's 10 months so wont be sitting on the loo for a while.
We make up the Movicol according to the instructions (mix with water 63ml?) the add milk and chocolate Nesquik...so like a chocolate milkshake.
One really important thing to do is insist they sit on the loo for up to 10mins, after breakfast, lunch and tea. This gets them into a routine, even if they don't go. Feet on a flat surface (stool) and sitting leaning slightly forward.
DS is now 5 and we are under prof candy who is good. An xray was really useful and really helped us all to understand far more.
Hi there....not sure if this is the right place to ask, but I need some advice on how to get Movicol into my 10MO. She's had problems pooing really since weaning on & off. Got quite bad 2/52 ago and lactulose wasn't helping so GP gave her Glycerin suppositories & Movicol. CANNOT get the Movicol in, though. Any tips? Really don't want her to start withholding. She sometimes cries when she's straining & am afraid witholding will be next. Her diet's good, BTW.
When my DS was withholding, I found www.eric.org.uk a helpful site.
Firstly let me sympathise - IT IS SO STRESSFUL!!!!!!!!!!!!!
My dd has withheld poo (and I swear to god) since she was a newborn. She is now on a sachet of movicol a day but my god we have been to hell and back. I highly recommend you get on the movicol. Ans try to stop talking about poo. I know it is hard but DON'T TALK ABOUT POO! At some points I have almost sat on my 3 year old to get her to sit on the potty. We have gone for DAYS without poos, screaming, crying, unable to leave the house incase she has a MASSIVE poo explosion, jesus it is a nightmare. Things are SO much better now. We have gone from 3 sachets of mov down to 1 now and she is in a good routine of pooing but it has been hard work. I HIGHLY recommend this book
All the very best. Things WILL get better.xxxx
Thanks noodles - I was a bit unsure whether I should bother with the GP or not. They said last time that as long as she was eating OK, happy, not lethargic, and not in pain, then I should just let nature take it's course...
I don't want to put her through having to have Movicol (or any other drugs for that matter) unecessarily. She is producing 'something' each day now - although not a lot I hasten to add
You all have my sympathy, it's so stressful.
Parched, YY to shouting & crying and crying in front of staff, etc. You are not alone!
DS is still on liquid Movicol on a daily basis, but he seems to have realised that if he doesn't poo on the toilet he really doesn't get the treats he looked forward to, like swimming and soft play. If he poos he always gets an ice-cream afterwards. He still has his activity books, but now we are saying, "We will play one game with you. If you do a poo, we will play another game in your room."
It seems to be working so far. I wouldn't like to say we're out of the woods, but I think we are getting there.
curly, if it was me I would go back to the GP and
demand request Movicol. The longer it goes on the harder it will get to resolve. Lactulose is good but it looks like your DD is withholding to the degree that needs something stronger.
marking my place here as I'm close to the end of my tether with 2.11yr old DD. She has been ptty trained since 2.4 but has always had poo issues (varying degrees from month to month). She has always held it in for a while and we had a trip to the GP back in Oct/Nov time who didn't prescribe anything just advised lots of water, fruit etc. Soon after, we got to the point that she would happily sit on the potty in front of the TV and would often do huge poos! so i thought we were making progress...
Anyway, at Xmas DD was poorly and then we went away for new year. She had a poo when we first got there which was the first one in about 5-6 days (which i put down to all the calpol/nurofen she'd had and that she hadn't eaten that much) and then because we were unable to take her potty with us, she proceeded to hold in any further poo until we were back in the UK 7 days later. She has been withholding ever since and it's driving me mad. She keeps asking for a pull-up to poo in (which i don't mind as i would rather she go) but even then she is still only producing a 'plum' size poo each day and her belly looks bigger than it should (although not really hard or anything).
I have been giving her some lactulose which I bought over the counter in the chemist, which has made the poo softer but isn't increasing the amount she is producing iyswim? I feel that she needs a really good clear out, but don't know whether to try the GP again or not. She is happy in herself and is eating and full of energy so I don't think it's affecting her too badly - it's me who is stressing!
Ds2 is too stubborn for rewards. He gets a jelly for sitting on the loo and a toy car if he poos on the toilet but still won't do it.... Little sod!
My daughter started to do this when potty training. She was doing so well then seemed to get freaked out by the toilet.
The biggest thing that made a difference was sooo stupid but I did start to get a bit desperate . . . . A poopy sticker chart!
Every time she went she got a sticker to put in a square on the chart and when it was completely full she got a stupidly expensive toy story doll. She was literally squeezing them out near the end of the chart just so that she "could win".
Ds2 was put back on movicol on Friday. 2 sachets a day. He had lots of liquidy poo yesterday but he's still holding some back.
When he's been withholding a while he gets overflow so we have a charming mix of poo refusing but constantly pooey pants. The pressure also causes him to wet himself constantly.
This has been going on since he toilet trained in September, although it started in as more minor way before the summer on a previous pt attempt.
He's going to be 4 on Saturday and our current situation is as prescription for 3 months of 2 sachets a day with a likely continuation beyond that.
We need to get him totally relaxed about poking before we even consider weaning off the movicol as he's proved simply shifting the blockage and stopping the movicol only makes things worse.
So on day 1 he had one sachet, two sachets on days 2 and 3, but still no "production" (as me and DH refer to poo in front of DS!) and have gone up to 3 sachets this morning. Trying to get DS to drink 180ml of juice was a bit of a battle though. He was running around on tiptoe trying to withhold so I sat him on the toilet, but he was still resisting. I ended up losing my temper, shouting, then crying and now feel like total s**t and a bad mother who is going to traumatise him further. I've burst into tears in front of nursery staff and work colleagues this morning
we had this problem with DD when trying potty training. We had 3 separate attempts and witholding was a problem every time. 3rd time we just dosed her everyday with lactulase and then we happened to be in a cafe and she shared a pretty rich chocolate brownie with me and that was it, we were in poo heaven. A month on she poos every day in her potty, no accidents or problems at all. I think she just 'got it'. (she was 3 in December btw.)
Yes, a record is a good idea because you tend to forget exactly what's been done when. The frustration is the worst thing, you can't help any more (than give medicine) but you're desperate to. Our DS just didn't seem to get it. He does seem to be catching on now, his comprehension has improved massively over the last few months (he has autism) and the points we make to him actually seem to be sinking in.
We pointed out that a) his poos are lovely and soft and don't hurt his bottom; b) if he doesn't poo in the toilet but holds it in, then we can't go swimming or to soft play; c) if he holds it in he will get constipated (he does know what this means, the nurse gave him a booklet they issue in these circumstances) and pooing will start to hurt again; d) he's a big boy now, and big boys do their poos in the toilet and e) he gets some ice-cream if he does a reasonable poo.
Previously all this just didn't wash with him. Either he didn't understand or he just didn't believe us. He was on liquid Movicol for a month before he started to relax slightly about letting it out, but it was hard going and there were LOTS of dirty pants, sometimes 3 or 4 a day. It IS getting better though, honest!
Re your question, it takes a while, to be fair - not just to soften the poo, but for the child to start to relax and trust that it will be OK to let the poo out. It has to be happen lots of times, consistently, before the poor LO can start to feel safer about letting go. I can't remember what the leaflet in the Paed Plain said about doses, but I would start with the maximum recommended dose and aim to very gradually reduce it.
(Why are my poo posts always epics??? Sorry for waffling on! )
TheNoodlesIncident - we have a book too. It gives me back a sense of control, even though I have none whatsoever (I sometimes ask myself if it's any wonder that I, as a control freak, have a child who is literally anally retentive).
I saw a locum doctor today who was very kind and I have administered the first sachet. As luck would have it DS did a poo on the toilet yesterday (after 30 mins of sitting there crying) so thought it best to start with a low dose. However, have caught him trying to withhold already and am a bit worried about an explosion. Anyone know how long it takes to get a result (IYKWIM)?
A little update from my ds, we only got to 2 sachets over 2 days and we had a day and a half full of poo(lovely soft poo!). Doctors advice was to then slowly reduce it.
I have him 2 sachets and have now tried one. If we have another episode ill know to stick at 2.
My ds suffered with constipation for about a year. It started when he was 2.5. He was prescribed movicol and we were told that it would take about 6 months of slowly reducing the amount to get it to work. It was a long process, but sure enough by the end of the 6 months he was regularly going every night before his bath and still is now at 6.5 . I feel for you - it is so distressing to watch. Some days both ds and myself would be in tears over it and when he did eventually go it would make small tears, which of course would make the process of going again even worse. Movicol is wonderful stuff and certainly hasn't had any lasting ill effects for ds.
We're still having trouble but DS is getting better. He was pooing 5 days out of 7 on average (yes we do make notes!) throughout December but had a relapse in January due to illness. He hardly ate anything and therefore had no need to poo, so slipped back into old ways. It was very upsetting because we thought he had cracked it, being so proactive in December.
He's 4 now and has had bowel problems since he was a baby. He's under the care of the Paediatric Continence Nurse and is prescribed Adult Movicol, as the Paediatric Plain sachets weren't working for us. Obviously adult Movicol is not licensed for use with children, so we get phone calls and questioning from the pharmacist (which is reassuring), to make sure that we are giving him the dose recommended by the GP, which is half the minimum adult dose. It works better for us because it is a liquid with a mild orange taste which can be mixed with any drink and doesn't seem to be objectionable to DS (which the powders were).
What we have also tried is telling DS that if he doesn't do his poos in the toilet regularly then we can't go swimming (or soft play, but swimming his favourite) any more. He might not be able to hold a poo in while in the pool, and that would be awful...
I do feel bad about this sort of thing, but I have tried so many things for so long without effect that we have got desperate. If it works, it works, and it's for his own benefit. He can sit on the toilet for ages (his record nearly two hours) without doing a poo, he's got so good at holding it in. He has activity books for looking at whilst he's there, that also seems to help.
The continence nurse has pointed out that it can take as long to resolve the problem as the problem has existed, so it seems we'll have Movicol on repeat prescription for a long time. As Yacka says, the bowel wall gets stretched so it takes time to return to normal.
Just a quick response - we had exactly the same problem with my DD. started around 20 months. We moved to potty training just after 2 to see if that would help but she still withheld it and would put it off so long that she got terrible pains in her tummy. We used orange juice and explained that the only way to get rid of the tummy ache was to go to the toilet and push it out. I went in and helped her push by telling her when to push. Sounds a bit daft now but we got through it in the end and although she puts it off sometimes its really fine now. I think it sorted itself out around 3 yrs.
Thanks everyone. I've got a doctor's appt for Monday, so we'll see what happens.
Just to let you know it does get better and it does end! My DS1 was terrible for witholding his poo and once went for 18 loooong day of no poos. I too him to doctors so many times, tried to increase his fruit intake, encourage him to drink more, doctor prescribed movicol but in the end it was psychological not physical so nothing we could do but wait it out. It was horrendous, DS would get himself so stressed out and in the end would only poo in his sleep in a nappy once every week or so :-( It was horrible and I ised to feel so stressed and even angry about it. In the end we just had to relax and try not to keep talking about it in front of him or make him feel bad for it. By the time he was 4 he for some reason would do a poo every day on the toilet. He's 5 now and we still have to remind him to go every day but I think he's just in a habit of having us tell him he needs to have a poo in the evenings so he goes and pretty much can poo on command now. If it was left to him, he probably would still only poo every 3 days or so but then it gets painful. Anyway main point is that it will get better, even if you do nothing.
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