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9 month old fissure and constipation

(17 Posts)
acquiescence Wed 03-Aug-16 23:37:20

My LO has had issues with constipation since starting weaning. It appears he has developed an anal fissure and screams in agony every time he poos. He was on lactulose which seemed to make poos bigger but still not very soft. He has now been prescibed movicol. He poos every day or two but it is never that soft and he is always in pain. I am struggling to understand how this is going to get better, how he will heal. I am taking special care with his diet, he has a lot of fruit and veg and we try to get as much fluids in as possible.

Has anyone got any experience with fissures (little tears in the rectum)/lots of pain with pooing and any tips on how to help him?

JinkxMonsoon Wed 03-Aug-16 23:43:19

How much Movicol are you giving him?

If it's not that soft, you can give more. Movicol is just a stool softener, so it's safe.

acquiescence Thu 04-Aug-16 09:14:07

Only half a pouch a day at the moment, the GP said half and up to 1 so will try that, thanks.

GirlWithTheLionHeart Thu 04-Aug-16 09:21:15

Put lots of sudocreme on his bum hole before bed and after a BM. I had a a fissure and after many different things this is what healed it. My dd has the same thing right now and I bought some glycerin liquid suppositories to help soften her poo and so it passes easier. Its so horrible watching them in pain

JinkxMonsoon Thu 04-Aug-16 10:43:50

Definitely try one sachet a day instead - that should make a difference.

acquiescence Thu 04-Aug-16 11:25:03

Thank you. I will increase to one sachet and keep his little bum creamed! I have been putting Vaseline or bepanthen on it once a day, will try and do it at every nappy change as I think it definitely helps . It is so horrible seeing him scream. The health visitor was so unhelpful- she said 'the most important thing is that he isn't on any medication long term' and to try stopping all meds to see if that helped?!

acquiescence Thu 04-Aug-16 11:26:07

I have a fissure myself from constipation after my c section having him- so I know his pain! GP has said there is some cream which should help but he won't prescibe while I am breastfeeding, very annoying.

JinkxMonsoon Thu 04-Aug-16 11:55:14

The health visitor was so unhelpful- she said 'the most important thing is that he isn't on any medication long term'

That's nonsense. Fissures can take months to heal, and unless the poo is kept really soft the healing fissure can be ripped open by a hard bowel movement and then you're back at square one. So it's more important to keep up the medication for as long as it's needed.

Tweedledumb0 Thu 04-Aug-16 12:24:03

Has no one looked at the possibility of it being caused by a gastro allergy? Constipation that isn't resolving, partic when it's triggered by weaning, should be a big red flag to at least consider this possibility.

The NICE guidelines on paed allergy handling agree: "Consider the possibility of food allergy in children and young people whose symptoms do not respond adequately to treatment for:...
chronic gastrointestinal symptoms, including chronic constipation."

You'll need to carry on with the movicol, but the HV is sort of right that it's not good for them to be on long-term meds where no cause is being investigated.

I speak from years of experience with a child with very severe gastro problems due to undiagnosed gastro allergies; keep up the meds, but get some decent input on what the underlying cause of all this is.

acquiescence Thu 04-Aug-16 14:37:30

Thank you. Tweedledum, sorry that your child has experienced GI issues. Allergies haven't been looked into, I'm guessing I would need to ask for a referral? Can I ask what specialist helped you in the end? Is a paediatric gastroenterologist a thing?

Tweedledumb0 Thu 04-Aug-16 15:29:52

I think an initial discussion with the GP, and yes, probably request a referral to exactly that, a paed gastroenterologist: I can vouch that they are indeed a thing 😀

JinkxMonsoon Thu 04-Aug-16 16:09:39

Come to think of it, my DD Was referred to a gastro at seven months when her constipation (since birth but worsened after weaning) caused a fissure. Her constipation is officially idiopathic though - no known cause. It's pretty common in babies and children.

Tweedledumb0 Thu 04-Aug-16 21:10:16

Mine's was officially idiopathic for nearly three years, too - till they worked out what was actually causing it grin

I think it is really common, and if you can control it well with meds, then no problem, but IME (and that of others, too), the idiopathic label is not a useful one to be stuck with if meds aren't working and it's getting progressively worse, as people stop looking for answers....

Tweedledumb0 Thu 04-Aug-16 21:10:57

Anyway, that's slightly off-thread - sorry, OP!

acquiescence Thu 04-Aug-16 21:43:52

Jinxmonsoon, can I ask how long your LO's fissure took to heal and if there was any intervention that helped?

Tweedledum not off topic at all, it is all interesting and helpful to me, I'm so glad I started this thread. I am going to ask for a referral to gastro and maybe think about doing some diet elimination stuff myself with him to see if anything helps. If you don't mind me asking what was your LO's issue and has it been resolved?

JinkxMonsoon Thu 04-Aug-16 23:31:18

I don't remember it being too much of an issue once she started the Movicol. She'd been so badly constipated for so long, it was a massive improvement just to get things moving properly.

Tweedledumb0 Fri 05-Aug-16 08:25:37

I'll pm you!

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