Withholding poos /stools(11 Posts)
My daughter started withholding before 1 years old but I didn’t realise she was doing this. She was taking herself away into another room when she needed to poo but we thought it was because she wanted privacy.
After a while we noticed what we thought was her trying to push out her poo but nothing was coming out for ages and then a tiny bit of poo would come out and sit in-between her bum cheeks. Also a bit of really smelly liquid would come out as well. She was doing this about 15 times a day. I thought she was constipated with a hard stool and she was pushing so hard it seemed like something was stuck. I went to the Dr and he gave us some laxative. This seemed to help very slightly but a week later it got worse again. I gave her more laxative but it didn’t seem to have much effect.
Went back to the Dr and said that I had noticed that although she was trying to push out her stools all day and nothing was coming out, that when it did it was soft which really confused me as to why it wouldn't come out. I thought something may be blocking her. He said that it was normal and once she is running around it will be fine.
Months later and by this age she was 2 years 2 months I was so desperate that I went to a see a Private paediatrician. He told me that in fact she was not trying to push her poo out at all but she was actually trying to hold it in. At first i didn’t believe this was correct but later that evening when I watched her doing it again I realised that when she was holding her shoulders up rather than pushing down and that she was actually trying to hold her poo in. The paediatrician diagnosed her with spurious diarhea due to soft impaction. Her bowel and large intestine had been packed with stool, although soft, for a long time as she had been withholding and only the liquid was getting through. He gave her movical to clear her out, which took about a week. Now her bowel is all out of shape and although it is cleared it doesn’t just snap back to the correct shape, it takes a long time to get back to normal. In the meantime all her stools fill all this extra space within her intestine and bowel. He gains she had been doing this as in the past she was probably passing big stools that hurt so it put her off wanting to poo. I must stress she is a big eater and drinker, she eats loads of finer and vegetables and never has hard constipation.
She has been on 6 movical sachets a day for the last 3 months to make sure she doesn’t withhold any more but she still seems to be able to hold some uneven though it is formless . She gets small amounts out about 8-10 times a day.
She is now 2 years and 8 months and I have no idea how to stop her doing this. She doesn’t want to wear nappies anymore. She wants to use a toilet to wee, she will not tell me when she needs to poo. When I put her on the toilet its very hard to get her to poo. She is not at all constipated she just doesn’t want to let it out. How am I ever going to get her to poo without withholding and soiling her knickers all day long?
Paediatician adviced us to ensure 5 mins sitting on the toilet, 20 mins after meals. (breakfast and evening meal, but also midday meal if possible)
If stool passed, then can stop sitting on the toilet afterwards, if nothing at 5 mins, then come off the toilet anyway. While on the toilet, make sure that feet are raised up on footstool (not dangling down loose), if possible play blowing up balloons!!! otherwise, just sitting.
Keep up the movicol until the holding has stopped, or you will return to constipation again.
Thanks so much for the advice Can I ask you how much movical you used. We have been on 6 sachets a day so it is completely loose. The problem is it just leaks out as its very runny. Shall i reduce the movival so there is more form to the stool?
Getting the balance right for the movicol is difficult, too little, the withholding restarts and constipation returns, too much and it leaks.
If you are sure that the impaction has cleared, then reducing the movicol til you get a soft formed stool is reasonable, but watch carefully if you need to increase it again, keep fluids up too. It will take time for the pattern to settle, and retain to passing stools rather than holding.
Thank you so much, your advice has been fantastic. Can I just ask you one more thing.... how long did it take for you child to stop withholding, I was told it will take about 3 years, does that seem right to you?
My DD first started withholding at age 2....she's just turned 5!! She got constipated once and just decided she wasn't going to go again. It has been a long battle and the Movicol is a long term thing for her. She did come off it after about 6 months initially but then randomly started holding on again a few months later. She has been on 1-2 sachets a day for the last year or so. The problem is that after a while the holding on becomes a reflex and therefore very hard to break the cycle because it's not even conscious anymore. I think it depends on the kid as to how long it will last - she is extremely determined and so I fully expect us to be doing this for a while yet! I'm not sure that helps, but I'd agree that getting the level right and keeping going with it for a while even if the problem seems sorted is the way forward.
Thanks for the advice, I really appreciate it. I was wondering if you daughter would her pants a lot on a daily basis, is it something I need to get used to or if I get the movical dose correct would it stop the majority of the soiling?
Weirdly, there have only been a few times over the last few years when she's had an accident and not made it to the loo on time. The girl is strong willed!! I was really worried about the potty training thing but we got through it. She is on 1.5 sachets a day and that's enough to get her going regularly but she can control it.
I'm not sure if you've already seen it but the ERIC website is a great resource for this stuff, I think they have a helpline too. There is also a specialist consultant who deals with withholding called Dr Cohn, based in N. London, I took my DD to see him. Good luck with it all, I know how stressful it can be!
Thanks 😊 I have spoke to Eric a few times and also read Anthony Cohns Boone which has been a real help!
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