dreadful bleeding nappy rash and stool witholding - heartbreaking :(

[humbergirl]

Hello, firstly, sorry for the huge post, i'm desperate for advice....
Here goes....

My 2 1/2 year old little boy has been witholding his poos for about 3 months now, we thought it was a phase, tried all the recommended methods from ignoring to explaining, books, etc.. but after many GP visits theres no improvement and he has the most horrendous bleeding, weeping rash on his poor bottom, its heartbreaking, latest visit was 2 days ago and we were given metonium, which has done nothing except maybe aggrivate, have been advised today by HV to apply sudocrem then vasolene, sadly as the rash is so weepy the creams don't hold. There are two problems here, the witholding and the rash, currently the rash is the most important problem in need of treating because he is suffering SO much, but it seems one can't be cured without the other.... and we have tried everything from fungal creams to pure aloe, to bicarb baths (not all at the same time each has had several days to see signs of improvement but nothing...) he's crossing his legs 'keeping it in' many, many times a day, each time a tiny bit of what the doctors call 'seepage' (sorry tmi, watery poop) comes out which needs wiping and here is the problem, its a vicious circle.

We've tried all the recommended books and methods, I just want someone to come along and say 'here's the cream, try this method' and something work and ease his pain, because nothing has so far, and being the bad guy and having to constantly bath, bathe wipe and apply, I feel wretched and spent most of today in tears (without him seeing). My son is potty trained for wee's and we spend as much time as possible with nappy off, but when he has a leg crossing holding in episode, bits leak out which we have been choosing to bath (up to 5 times a day) instead of wipe, as the wiping takes off the top layer of the rash and it bleeds.... we've been told we are doing and trying all the right things and that 'it won't be forever' but he's 2 1/2, he's in a lot of pain and he doesn't understand any of this, he is hurting so much. Has anyone been through this?

Thanks for reading.

[3littlewomen]

Hi Humber. Poor you and poor son. I am so sorry you are going through this. I have no experience of withholding but I am sure some more knowledgable parents can help with that.

I have however had a few with bleeding nappy rashes. After trying bepanthon and sudocreme (a cute for everything here in Ireland) a neighbour suggesting "painting" the bottom with very lightly whisked egg white. It dried to form a barrier and really stops the cycle. It is topped up at each nappy change. Obviously assuming no allergy problems, this may be worth a try.

Hope it gets better soon

[headlesslambrini]

I'd try talc, non perfumed stuff. It should help to dry it up. As soon as it starts to look a little dryer then start with sudocrem and vasolene until it goes. Continue with no nappy and keep to the air as much as possible. Also when he does goes, try to encourage him to put his hands on his bum cheeks and slightly pull apart to get as much of the skin out of the skin out of the way as possible.

[Opheliabumps]

Something we tried when my DS had awful nappy rash was a piece torn off a muslin (about 1/4 or 1/8th of a muslin) soaked in cooled camomile tea, placed into his nappy overnight. It worked absolute miracles, the rash improved vastly just in one night.

You have my sympathy, ti's awful when they're in pain

[BerniceBroadside]

Ok, the withholding is possibly the easiest one to resolve. You need movicol. The gp can prescribe. You need to use it to clear him out then work out the maintenance dose to keep him having a soft stool daily. Read the ERIC website, it's very helpful for continence issues.

www.eric.org.uk/

I think you may need a referral for the rash. Have they tried anything like a mild steroid cream? No idea if it would work, but if the barrier creams and normal nappy rash creams aren't helping might be worth asking about? Also, have you considered a food allergy/intolerance? Are there any foods which seem to make it worse?

[noblegiraffe]

Have you been given anything for the withholding? Lactulose? Suppositories?

My DS withheld from when he was 6 months old and suppositories every 3 days were the only thing that made him go.

If watery bits are seeping out, that could mean that there is a blockage that needs to come out and poo is simply seeping around it, which obviously isn't good.

The rash sounds horrendous, no wonder he doesn't want to go.

[MrsSpencerReid]

Have you tired a thrush treatment for his bottom? Might be worth a try if nothing else has worked, sounds like he needs something to help with the pooing too, hope it doesn't last too much longer!

[IHaveSeenMyHat]

Sorry, have no advice for the nappy rash, it sounds horrendous. Don't underestimate the seriousness of the withholding though, because that can take years and years to get over.

You need Movicol and lots of it. You need to get his stools so soft he physically cannot hold it in. You'd need to keep this up for months, until he stops associating bowel movements with pain.

[Artistic]

I once saw a TV program in which a man had psoriasis on his bottom & was suffering horribly when doing a poo. This could be wildly wrong in your DS case, but are you sure the diagnosis of nappy rash is right? Could it be something more serious that needs steroids etc?

[humbergirl]

thank you everyone, we have tried movicol, for maybe 2 months, it certainly softened the stools more, but because they were so soft and sticky it meant more wiping on a very regular basis as he was still holding in as much as he could which meant more very small deposits in need of wiping/bathing, so we came off it in the hope of firming them up a bit so we wouldn't be looking at 10+ episodes of small amounts/cleaning/cream, i just don't know what to do for the best, its so upsetting, its almost like it needs a dressing but as its on his bum, can't...

May try seeing if he will hold his bum cheeks apart, problem is he is so distressed at this point that he won't listen to anything, he just wants to keep it in. He will sit on the potting during these episodes sometimes but he still tries to cross his legs, another problem is he insists on using the oldest, smallest potty and despite buying several others he just won't use another one... we've tried asking him to choose one, he just gets upset and cries so we haven't pushed the issue and let him use the small one, despite telling us its uncomfortable, we also have a toilet seat adapter but he isn't keen on that either... poor baby, its all so worrying, I try to keep a cheerful face on and act normal but its hard x

[noblegiraffe]

Ask the doc for some suppositories. They are unpleasant to administer, but we found that at least they produced a good sized stool. Sometimes we had to use more than one until he went, but they worked.

[Clint88]

What a fabulous patient lovely mum you sound :) I second the egg white and would give the chamomile tea/muslin a whirl too.

My heart goes out to you and your boy, toilet issues are horrible. Is there a children's continence nurse you could be referred to? They might have some ideas.

[Moggy72]

This is a bit messy but would try no happy when he is awake. The rash is aggravated when it gets damp. Put the sudocream all over and then leave him naked from waist down. Try to get him to run around as much as possible.

[Moggy72]

I meant no nappy :)

[BerniceBroadside]

I think you need to try the movicol again after starting with a good clear out. Do look at the Eric website, it's very helpful. Two months isn't long enough to be on movicol, in the majority of cases.

A referral to a specialist in child continence issues may also be a good idea?

[humbergirl]

Thank you, I've asked for referrals but at this stage the doctors still think 'watch and wait' is the best option, I don't really agree as watching your baby (i know he isn't a baby but he's my baby) suffering isn't something you want to just sit out...

Forgot to mention he's been prescribed steroids today but that was just before the chemist closed so haven't been able to get it today, I know they thin the skin and can have damaging long term effects but it's only hydrocortisone 1%, worth a try?

Health visitor can't visit to observe him for 10 days which is a long time when things are like this...

I will take a look at the Eric website, thank you for continued support, it's good to hear some ideas and voice my concerns x

[humbergirl]

Maybe will try the egg white too. What is it I'm supposed to do with it?

Have been doing nappy off all day, it is messy with the creams and leaky bits but have been avoiding nappies unless we are out or at nighttime, we've been staying in more than usual to try to get more 'air time'

Thanks again for kind words of support

[drinkyourmilk]

The little boy I look after does this.
Wrt the withholding I can't help, but I'd love to know the answer!
The nappy rash- use only water and cotton pads or cut up fleece to wash. Dry it with a dry cloth. A thin layer of sudocrem. I use this method regardless if there is nappy rash or not now. Keeps on top of it.
Nappy free time a couple of times aday- I've found laying down watching a bit of TV works well (then you can put a towel underneath incase of seepage).
I've stopped wiping every little mark. It makes the rash worse despite what you would think.
Hope it clears soon.

[80sMum]

Sounds crazy but cornflour is good at drying a weeping rash.

[AcrossthePond55]

My DS2 did this at about the same age. I can still see him standing in a corner with crossed legs and red face, holding it in. We used suppositories (with Dr's advice) and chocolate as 'bribes' for producing a BM. The suppository part was not pleasant, but it did work.

For nappy rash, I recommend Boudreaux's Butt Paste if you can get it there.

[Redorwhitejusthaveboth]

Stop cleaning with water... Use cotton wool dipped in olive or veg oil... Or aqueous cream - they are really gentle ways of cleansing sore nappy rash. It's trial and error with regards to creams... Basically you want something to heal the skin whilst creating a barrier. Sudocrem usually is brilliant but has never done anything for my sons bottom! He needs an ointment based cream - we have emulsifying ointment - and eumovate ointment for when it's sore. Metanium mixed with Vaseline can be really effective too.
With regards to the poos he sounds constipated - I tried movicol for my son with no effect... But senna and lactulose do work... You need to up the dose until he is cleared out. Ask for as referral to a continence specialist and check out Eric.com for more advice and support.

[NoWuckinFurries]

DS1 had the most horrendous nappy rash as a baby which wept and scabbed over, almost as if he had been burnt. It was heartbreaking to see him in such pain. It turned out to be a reaction to the nappies he was wearing (which coincidentally had a very strong "chemical" smell to them when first putting them on) . I changed brands and within a couple of days the improvement was noticeable. It might be worth giving it a try, especially if you are using nappies for long periods at night when the problem could he occurring? I hope you find a solution quickly.

[CrewElla]

My DS had a terrible weeping nappy rash and we tried all the nappy rash creams. What finally worked for us was a barrier cream by 3M, Cavilon. It is often used in hospitals foe stoma patients. It is non-stinging and gentle.

[LadyFlumpalot]

DD has recently had a weeping nappy rash, in desperation one night I used the tube of Lansinoh I'd bought for my nips but never used. That worked well.

[3littlewomen]

Hi there, sounds like you have had lots of fab advice.

I which the egg very gently for a few seconds - just to break down the whole lumps (don't think meringue), then paint it onto dry well aired bottom using a silicone basting brush. You'll feel mad doing it - but in my experience it really works!

[3littlewomen]

Whisk!!