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How common is chronic constipation in young children really? / some wider problem?

(37 Posts)
perceptionreality Fri 04-Jan-13 20:56:59

Dd3, aged 3 years, 8 months is terrified to poo. This has been going on now for about 18 months at least. She will use the toilet to wee, but given the choice will not poo at all. Movacol does absolutely nothing. When she needs to poo she goes to lie down on her front and holds her buttocks together until it goes away. The GP gives me suppositories which I have to put in which is the only thing that will result in the poo coming out. Then what follows is about 20 minutes of crying and screaming until she finally goes in a nappy. When she is going she looks terrified. I have tried endless things to reassure her - stories etc and will always help her and talk her through it when it's happening, saying it's normal etc.

I have taken her to the GP many, many times but they say there isn't anything they can do about it except prescribe movacol and suppositories and of course I do see that the problem is psychological anyway.

The GP said this problem is very common in her age group - is it though? I have started to worry because she is due to begin school this year. I have also started to note other things about her which cause me to wonder if she has some undiagnosed problem - ie she hates having her teeth cleaned or her hair brushed and she screams the house down unless she can leave with her dummy, blanket, bear and drink - which she has to hold all of. She also needs to be in control of everything and gets very stressed if she can't. Lately I have noticed she wanders about the house reciting scripts from television programmes - this concerns me! (my older dd with ASD did exactly this). I always thought dd3 was unlikely to be autistic as her first word was 'no', which she used properly and in context well before the age of 2.

Nursery were concerned about her language development last year but then over the summer holidays she progressed a lot and they are now happy with that. It was put down to the fact she has glue ear. When the HV tested her language it was found to be slightly above average.

I am not sure if she seems quite normal though. Any thoughts?

incywincyspideragain Fri 04-Jan-13 21:17:44

I'm sorry no direct experience of this - hopefully someone else will be along soon but could the other sensitivities ie teeth and hair be a result of her bowel/poo not being right? combined with the frustration and disorientation of glue ear? If you can't hear very well and struggle to poo I can image you would want to control as much of everything else as you could.
So sorry no advice on how to help but sounds like an issue with her gut - have you tried complimentary therapies? when I was disaparing with everything I tried homeopathy and a nautrapath for ds's and dh, it worked wonders (and still does) imo

incywincyspideragain Fri 04-Jan-13 21:19:45

I've reread it.... the poo thing doesn't sound normal, how does the GP see it resolving? or are they suggesting movacol and suppositions for the rest of her life? at this point I'd be looking for alternative treatments

spookycatandfluffydog Fri 04-Jan-13 21:25:22

Definitely ask your GP for a referral to see a paediatric gastroenterologist. My child had chronic constipation from age 1. It turned out to be due to a dairy allergy.

perceptionreality Fri 04-Jan-13 21:26:55

Thank you, I had not thought of complimentary therapies - the GP says she will grow out of it but I'm not convinced. And I'm also not convinced this happens all the time - I don't know of another child her age who is like this. Nursery have also said that there is no easy answer to the problem. I see your point about the need to control things - thanks for giving me a different perspective.

FiveGoMadInDorset Fri 04-Jan-13 21:27:11

Ask for a referral, GP's were inaffective with DD. Don't get fobbed off, we have spent the last two and a half years being told by the community pediatrician that DD was not constipated as she couldn't feel any blockage in her bowel, we have been to see psychologists to see whether it is in her head or to do with her asperger tendancies. Turns out she has a severe blcokage in her rectum which has only been diagnosed afte an xray ordered by a specialist nurse we have been referred on to. Doasge upped massively and then a very slow come down. Tip that she gave that has worked is to blow a balloon everytime she sat on the loo as it would help with the pushing technique. You are one step ahead though as DD wasn't continent until recently due to the blockage.

spookycatandfluffydog Fri 04-Jan-13 21:27:46

Also a developmental paediatrician?

seaweed74 Fri 04-Jan-13 21:28:17

I'm no expert but delayed language development does not have to be present with ASD as far as I know. A lot of what you describe with your dd3 sounds like she has sensory issues. The problem with withholding poo sounds pretty awful. Have you tried giving high doses of Movicol? How much Movicol is she taking daily? Is it possible that it really is very painful for her to go? Tears or such down there?

I don't know if the problem is very common in this age group. My dd1 is 4 years tomorrow. She was diagnosed with ASD in February last year and has been on Movicol since 22months old when she went 11 days without a poo. When she finally went it was horrifying to watch sad. Problems pooing seem to be common in dc with ASD.

I think you need to ask for a referral to a developmental paediatrician. Have you told the gp of the other concerns.

spookycatandfluffydog Fri 04-Jan-13 21:29:54

Also would recommend routine - i.e. Sitting on the loo after breakfast and after tea.

perceptionreality Fri 04-Jan-13 21:31:05

I've already asked for a referral - the GP refuses. Perhaps I could try another doctor.

FiveGoMadInDorset Fri 04-Jan-13 21:33:17

It is your right to get a referral, I would see another Doctor and put a complaint in about this one.

spookycatandfluffydog Fri 04-Jan-13 21:35:21

Is there another GP in the same practice? If so book an appointment with them

perceptionreality Fri 04-Jan-13 21:35:53

seaweed - I have an older child with classic autism so she is totally different. But I remember reading George & Sam by Charlotte Moore - she didn't realise Sam had ASD at first because he was so different from George. But my feeling is that something may be going on here. I don't think I am going to be able to get a referral easily here. I had to pay for my older dd's diagnosis report and as I said she is severe and had no language at all.

Hi op. I had this exact problem at this age (my mum loves to remind me!) I did get over it. The pooing-phobia developed after very bad constipation which hurt so I was then scared to poo.

What you're doing it good re reassuring etc but because of the other issues I would see another gp and push for a referral

TeWiSavesTheDay Fri 04-Jan-13 21:42:42

I have a DD who had similar issues (same age too!) She was prescribed lactulose instead of modicom as the GP I saw felt it was better at forcing dc to Poo than movicol. I think you definitely need a different GP and a referral.

Really have no idea about the AS/HFA possibility because I have the same concerns but am waiting until she is older to see if her social skills improve.

TeWiSavesTheDay Fri 04-Jan-13 21:43:27

Movicol not modicom, stupid autocorrect.

TeWiSavesTheDay Fri 04-Jan-13 21:46:08

Also, have you read "constipation, withholding and your child"? I found it really helpful and made a big difference to us. DD has come the rest of her way by herself by nighttraining - not wearing nappies at all seems to have cleared it all in her head.

TeWiSavesTheDay Fri 04-Jan-13 21:47:40 Constipation book

seaweed74 Fri 04-Jan-13 21:50:22

Wow OP. I have clearly been very lucky with our care and help or you're really unlucky! Second trying to see another gp. I got dd1 referred to community paediatrician at 22 months by gp for no standing at that point. Amazingly got appt at 23 months and diagnosis of hypermobility at that point. As already in system and full developmental check done at this point, delays in other areas were also noted at this point.

By chance when dd1 was 2.7 years we were about to start a new session of speech therapy so I noted down her vocab - was so proud of her 17 words at the time! Anyway that's why I realised that only a few months later we were down to 5 words. It was a conversation between dd1's physio and speech therapist following chats separately with me that got us a referral to the communication clinic for diagnosis of ASD. Following diagnosis we realise how many red flags we'd not noticed or ignored blush. I'd done the mchat when dd1 was 18-20 months too and that had indicated ASD.

Can/would HV refer your dd to paediatrician especially with your other dd's diagnosis? Different gp? Does your current gp know of your other concerns as well as the constipation? If not a referral to a paediatrician, would gp refer to a specialist nurse re bowel problem?

Sorry for firing off questions.

perceptionreality Fri 04-Jan-13 21:51:16

I have tried giving 6 sachets of movacol a day but all that happens is that a small amount of poo dribbles out. The suppository is the only thing that makes her go. When she does go, afterwards she'll say 'I feel better now' and the poo looks normal (ie not hard or difficult to pass).

seaweed74 Fri 04-Jan-13 21:59:40

I don't have the Movicol patient info sheet to hand so can't check what it says, but remember our paediatrician saying that my dd was taking a tiny amount of Movicol compared to many children. He mentioned some dc being on 10 sachets a day! Definitely sounds like a blockage somewhere. Liquid seepage indicates some solid matter somewhere blocking the passage. Some dc end up with a sort of "pocket" in their bowel where poo collects.

perceptionreality Fri 04-Jan-13 21:59:55

She was very late sitting and walking - sat at nearly 1, walked at 18 months. She still runs a bit like a baby (iyswim). The GP doesn't know of my other concerns because it's only recently that I've noticed how obsessive she is about everything.

I have made an appointment now with a GP who is known to be good. Hopefully I will be able to get him to refer. If not looks like I'll be paying £1000+ for a full assessment again. I can't let her start school without these things being investigated first - it wouldn't be fair on her I feel.

perceptionreality Fri 04-Jan-13 22:01:08

Well she did a poo yesterday and it looked totally normal but just a lot of it. It is only when I give her movacol that it goes runny.

seaweed74 Fri 04-Jan-13 22:06:44

I'd write down all your concerns re dd3 so you don't forget anything when you see gp, and mention your older dd's diagnosis as new gp should be made aware of family history.

Good luck.

perceptionreality Fri 04-Jan-13 22:09:11

Thank you seaweed - I will start to write a list of her behaviours.

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