Faecal impacting

[eosmum]

Anyone here any experience with this. Ds (6) is on day three of double the adult dose of laxatives plus movicol paediatric twice daily. I believe the problem is due mainly to a lack of fluid and fruit and veg in his diet, not a physical reason. His poos have been only watery for the last two days, ( lots of it) is that right? I thought some of the blockage would be more solid. I have to do this for five days.

Now I am at a loss as to what to feed him? I thought I was doing the right thing giving him minibix for breakfast, but he only eats them dry, so from reading I think this is wrong as he's not having enough liquid and this is causing the fibre to absorb the liquid he is drinking. He is a terrible eater, lives on toast, do I make him have brown, or white? I have to sneak veg into things like burgers, meatballs pasta sauce, but I still don't think it's enough. Ive started making smoothies for breakfast but having to force him to eat them. I never wanted food issues, so never forced him to eat and now this is all my fault. We're in Ireland so the health system is different to UK, so the treatment may be different. Tia eos.

[NoPartyDay]

Fruit salad?
Veg soup/minestrone/pumpkin soup?
chopped carrot lengths/cucumber/mini tomatoes and dip?
porridge, milk and golden syrup/honey? stewed apple?
macaroni cheese with 1/4 cup mashed steamed cauliflower?
spaghetti with finely grated zuchinni in the tomato sauce?
Don't worry they improve eating habits in time, keep offering more fruit and veg (my oldest-13, will eat anything now, my youngest,6 often fussy)

[LondonJax]

First of all, don't put all the blame on yourself. Our son was perfectly fine with his poo until he started at pre-school. Then he realised that, if he held his poo in, his play time wouldn't be interrupted. Then, of course, it became painful to pass a poo...then the soiling started...

Finally, when he was coming up to four (having had 9 months of laxatives, movicol etc with a limited success) we were put in touch with a specialist who said the holding had caused his bowel to stretch so he wasn't getting any sensation of being full so wasn't aware he needed to empty his bowels - causing soiling by poo leaking out (I know TMI).

And, because of the stretching, the bowel had forgotten how to contract. So DS was on movicol and senna.

We've just managed, over time, to get him down to half a sachet of movicol three times a week and 2 teaspoons of senna every other night. We're reducing the movicol by a day a month, then we'll do the senna. He's literally just started becoming regular and full in his bowel movements, though he still soils (I think that may be the movicol making things to soft now the bowel is getting stronger).

The point is that DS always has 2-3 veg at night, loves cucumber and carrot chunks as a snack (as well as the usual biscuits etc though we limited these for two years - didn't make any difference). He has two portions of fruit most days and eats wholemeal bread usually. He's not great with drinking though we encourage him to finish a glass at each meal. So I do soups and add gravies to as much as I can when he eats at home. It's not made any difference - his bowel problem is caused by holding, not by what he eats. I must admit I can't understand how they can hold it all in! If I need to go, I need to go!

[Badvoc]

Would he eat a fruit purée pot? I use organic ones. It's the only way my eldest will eat fruit.
Soups?
Do add more protein to his diet, a carb heavy diet is not good for anyone, and yet most children seem to crave them.
Switch to whole meal bread and rice and pasta if you can.

[eosmum]

Thanks guys, he is an incredibly poor eater, could go the whole day without food if not reminded. I'll look at the fruit pots, I do already shred onions, carrots and courgettes into homemade pasta sauce, the annabel karmel recipe. But he only eats a couple of teaspoons of it, won't touch porridge, soup or raw vegetables.

Interesting what you say LondonJax, your post sounds very like they way things are here, he does hold it and won't give himself time to go. He says it hurts to go, I thought a fissure when I took him to the GP, but she felt his tummy and sent us straight to A&E. The hospital never mentioned this at all as a cause or contributing factor. They did say that it will take between 1 and 3 years to sort it out, so he could potentially be nearly 10.He has a megarectum (sp) and it is not working at all, not contracting, and only the build up behind is actually moving anything along, he has tummy pain and it's very swollen, so must be very uncomfortable. How long have you been doing all this? Sounds like years from your post.

I've kept him home from school today as they can't deal with a poo explosion, but he has to go back tomorrow, I'll send a change and wipes and if there's a problem they will ring my MIL who will come to clean and change him. Today we have talked about it all, measured out how much water he needs to drink and how much fruit and vegetables he needs to eat. We've made a sticker chart to keep track. I will get senna if that will help. Thanks you all for all the advise.

[Badvoc]

What about dilute prune Juice?
Sorry he is having such a hard time.
:(

[LondonJax]

Sorry, I forgot to put DS's age. He's 6 next week, so it's been 3 years in total since we first spotted the problem, and two years since we saw the specialist. We were warned that it'd be 18 months before the bowel performed properly - he was so bad that his bowel leaned on his bladder and upset the signals for weeing at one point. So if it wasn't poo it was wee or both at once argh!!!

The specialist did a letter to his school to say he had a special medical need so we've had no problem with them and one of the TA's has kindly agreed to help him if he soils at school. When he was in Foundation he and three (!) other children had the same problem so the school got funding for an extra TA who would cover the changing of soiled pants (lovely job - three or four times a day!) He's now down to one or two soils every so often and by no means daily.

We give a coloured token to put in a jar (10 tokens of the same colour give him 10p). He gets one colour if he has clean pants at bath time; another colour if he does a poo on the loo and the third colour for sitting on the loo to do a wee (as that means, if a poo is there, it will start to move down). DS always prefers to wee like dad but we've had to put a stop to that as it doesn't encourage poo to come out. We broke it down as it was hard for DS to get any tokens - he'd do a poo on the loo but have soiled pants - and we just felt he needed to feel like he was winning the fight. It seems to be working as he's so proud when he gets a token that he tries harder to do well and get a different one.

When he had the problems with not getting the wee signal too we used to give him a token for sitting on the loo for a set time (5 or 10 minutes) at set times during the day and we used an alarm clock so he'd know when the time was up. It also made sure we didn't forget in the general bubble of the day!

There is an excellent website called ERIC which gives tips for parents of kids (or the kids themselves) who have continence or soiling/poo problems. They have a great tip for helping a child sit on the loo and push (without realising they're pushing). You sit the child down, get them to rock back and forward (that helps move the poo down) and, as they sit up they either blow up a balloon or blow into one of those blow out things you get at parties. The blowing action makes you press down on the bowel. Try it, take a deep breath and do a hard blow. You feel your tummy tighten...you do that repeatedly for the time they're sitting on the loo.

The website address is www.ERIC.org.uk. They have lots of ideas and things you can discuss with the kids plus a forum too for support.

By the way, don't add anything like senna to the mix without asking the doctor. They've probably got him on something in the mixtures he's having and it could upset the balance.

Hope it helps.

[LondonJax]

By the way, the issue with not eating much could be a symptom of the constipation. Within a few months of the movicol beginning to work with DS we noticed a change in his apetite.

Now DS always seems to stop eating so well if he's 'backing up' so we make sure he sits on the loo more frequently and, as soon as he's been to the loo properly, he eats like he's been starved for weeks!

[eosmum]

Thank you all especially you londonjax, that website is just brilliant, even with all the googling in the world there is nothing like speaking to someone who has been there done that. I was reading yesterday just couldn't reply on the phone. Did try the blowing and rocking no output though. Going to buy one of those padded toilet seats as he says it hurts his legs, :) he was certainly eating a bit better, even had cereal with milk before, has never had wet cereal before. I'm in work now and hate leaving him to school in case of an accident but it has to be done. I won't get the senna, I thought it was just a health shop supplement didn't realise you'd been prescribed it. Thank you very very much again, I'm much more confident in how to deal with it now. Eos

[LondonJax]

I feel like I'm stalking you Eos! Glad you found the ERIC site useful. One thing that worked, eventually, for us was allowing DS to sit on a potty...I know it sounds weird, a 5 year old sitting on a potty, but having his knees above his hips and being able to push down with his feet seemed to help the poo come out.

It will take time. At one point we'd spend 15 minutes on the loo just to get the minutest poo out. Then it increased to a large poo once a week, then down to every 3 days and finally, three weeks ago, DS came running upstairs shouting "I need the loo, a poo is coming". In the three years he's had this he has never been able to say when a poo is coming. Bear with it, he'll get there.

Good luck.