2 year old had an anal fissure and now TERRIFIED of having a poo... Help!(14 Posts)
My DS potty trained when he was 25 months, and never had a soiling accident. He moved really quickly to a big toilet. He'll be 3 in a few months. About 6 weeks ago, there was blood in his poo and he was in real pain. A Dr diagnosed an anal fissure (cut inside the anus) and recommended laxatives to keep it soft while it got better, he warned it would take ages to get better and was mainly psychological. He was right!
Now my DS won't go near the toilet. He does "standing up wees" but absolutely won't do a poo. He can go for up to 7 hours absolutely frantic - shouting "I need a poo", doing urgent leg wiggling, bending over, crying... Bits of poo leak out so we have to keep changing pants and trousers. The odd time we've had him with his trousers off just as the poo is coming and he'll sit on the toilet and push it out. If we try to put him on the loo before it is actually appearing, he gets hysterical and fights. He kicks his potty around the room if I suggests he uses it. He won't wear nappies or pull ups (we have suggested that in a non-critical way). He absolutely hates pooing in his pants - cries a lot when it happens. He's not in pain anymore. Once he has pooed he will say very calmly that it didn't hurt, that he will poo on the toilet next time and that Big Boys don't poo in their pants. I've been frustrated with him the odd time (it is v stressful) but I have only shouted at him once which is when we were out on Wed for my Mum's birthday and I had taken him to the loo three times and after the third time he immediately pooed in his pants. I felt guilty :-(
Nursery are suggesting that I get cross and force him into nappies. I hate the idea of making him feel bad. But it is getting so stressful. Any top tips GRATEFULLY received......
Get back in contact with your GP and ask them for advice.
The placebo effect? Could you give him a medicine (sugar water) that will 'make sure pooing doesn't hurt'? It would only work if there is no pain, obviously.
What does the GP recommend? The HV? Could a child psychologist be of some help?
Try distracting him with a book or a song. If you sing Row Row your boat with him and do the actions, it will actually get the tummy muscles moving and working too so he may manage to poo without really noticing too much. Also try blowing some bubbles, a fun distraction for him and again will get the muscles moving.
I think an anal fissure led to poo witholding with DS, I am on my way out now so no time for a long reply, but I did start a thread about it, and it is here Witholding poo thread.
It takes a lot of patience, and Lactulose! The book that Feel My Wrath linked to is terrific. Also Poo Goes To Pooland - not a printed book but on the www, link in my thread somewhere.
If you're sure it's psychological how about a star chart? 1 star a day for no soiling, nothing if he does (ie don't give him a star but don't take one off him) and set a reward for a week / 2 weeks etc?
Thanks all. Have tried GP three times but will go back this week. We have tried star charts, massive cheering if he did it on the toilet (I thought he was better as he did it 4 times in a row on the loo last week), sugar water as a placebo....
I love the Poo Goes To Pooland book - we will definitely read it.
I am so worried about doing something wrong and making the situation worse...
Have you got your doctor to prescribe 'magic cream'?
When my daughter had her run of anal fissures we used lactulose and then the doctor also prescribed Proctosedyl Ointment. If your son knows he is going to do a poo, when he tells you first, you put the cream on and it anaesthetises the area. Within 5 mins, they won't feel a thing. I used it after I had a fairly horrific birth and lots of damage down there, and I can vouch that it really does work . Just make sure he remains dosed up on lactulose (you can buy that over the counter, you don't need a prescription for that) and that should solve it.
My friend's daughter was too young for the ointment (too young to say she was needing a poo) and she was given a different type of medicine which she just uses regularly. Forget the name, but it starts with a M.
Lots of children have them, its no biggie and 'magic cream' really does work. Good luck.
I know it's no laughing matter, but superb choice of words in LadyLech's last sentence
My DD takes lactulose. If the dosage is right and the poos are soft enough it should not be painful I think. We were told 2 x5ml per day by the GP which is double what it says on the bottle. Most of the time we stick with that but I reduce it if poos are very very soft.
When she has a good dose of this I would say it is impossible for her to hold it in.
I would ask GP again. Poor wee thing I hope the situation improves it is very stressful to have these sort of issues.
Both of my children have been poo withholders! DD required months of movicol to solve the problem. With DS we solved it ourselves as he has an ASD and getting him to take medication is a nightmare!
With DS we used a star chart BUT it was a reward for pooing. I had a treat bag and every time he had a poo he got a sticker, 3 stickers meant a treat. To start with he got a sticker for a poo no matter where it happened - he often used to poo in the bath (grim I know but needs must!). I was just rewarding the letting out of the poo! Over time we increased the number of stickers to get a treat and also the sticker was only available if the poo was in the loo.
Lots of water. DD was also better if she's eaten malt loaf!
Poor lad. I strongly disagree with nursery saying that to you. I used to work in childcare and have heard stuff like this said before. I can't offer much advice on this but feel for you it must be difficult. I think putting him back in nappies may upset him further. Good luck. X
Thanks All (again!). We've been on the lactulose for weeks, he has lots of it. He's definitely not in pain anymore - he's just scared. He did manage to have 3 poos on the toilet today (yes THREE!). One at nursery and two at home, although the ones at home were because I lifted him on when he was "going". He was very proud of himself. I'll take him to the doctor's on Friday and we have started the poo and Pooland discussion... Thanks for reassurance everyone. I very much appreciate it.
timeforacuppa Movicol will keep the stool soft so that will help pain, also Senna at night will ensure he really has to go first thing.
IMO I would ask your GP for a cream or ointment that contains an anaesthetic and tell your DS this will stop it from hurting. Sounds like today has been a great day though! Loads of praise etc, and perhaps talk to gp about staying on Movicol for a few months to avoid problems again.
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