Long term constipation

[naturalbaby]

Ds is nearly 8 and has been on medication for constipation for 3 years. It started soon after he was potty trained, before 3 years old so at first we tried to control it with diet and reward charts. The doctor says there is no clinical reason for him to be having problems and we have other minor concerns about his behaviour so have asked for some form of therapy. We're not getting anywhere though - still waiting for a referral.

He's a bright boy and very reward driven, we have a good routine - eat well, drink lots, sit on the toilet for up to 10mins after every almost meal. We've tried daily rewards and building up to bigger rewards but he can't maintain progress. Once he's had a big reward it's back to square one.

Can anyone tell me what's worked for their child long term? I wonder if there is something like a feedback issue - he says he doesn't feel a full bowel at all and very rarely says he needs to go. He has no issues feeling a full bladder though.

[tickingthebox]

1. Sitting after every meal is too much... I get my DS to 'sit' once a day - however if he has had constipation he won't get the sensation of needing to go as his bowel is stretched so he will have to wait a long time before he feels anything. DS is 10, and still doesn't have a feeling of needing to go.
   
   
2. I would try to work on yourself finding out the cause, no one ever identified it for DS - it was me in the end and a random comment from a friend.
   
   
3. Ds does generally need more fibre than the rest of us, and even now we have the cause sorted out (too many eggs believe it or not!) we have to make sure he has brown bread/ rice and pasta, Also he has to have his 5+ portions of fruit and veg a day, whereas his brother can "get away" with white bread and less fruit etc.

[tickingthebox]

I should just add we had a very healthy diet and he was still constipated, we definitely have to go the extra mile to keep him regular!

[naturalbaby]

The doctor recommended sitting after every meal. If he's passed a good amount after breakfast then that'll be it for the day.

I just don't know what else to try diet wise- he's a fussy eater but eats fairly well.
I'm desperate to find a cause. I'm sure behaviour is playing a big part. It's so frustrating knowing then solution is out there but we haven't found it yet.

After 3 years of medication, how much longer till the baggy bowel issue is no longer a factor? We were told twice as long as he had the issue for, so 2 years of constipation and 3 years of medication means we're nearly there?! (Clutching at straws!)

[Yogagirl123]

My DS has also had problems with constipation. We saw a Paediatric Gastroenterologist privately last year as the wait under the NHS was far too long etc. We were at our wits end by this time, as DS was suffering badly. The consultant was totally amazing, we had seen others in the past, that couldn't solve the issue. The consultant advised us 1 year of medication for every year of constipation. He warned us that if we stopped the medication earlier, we would soon be back to an acute stage. Good luck OP.

[naturalbaby]

Did the consultant advise anything else? Ds has been on medication for 3 years but I really feel he needs something else. It's almost become a normal part of his routine and in principle I don't like using rewards to change behaviour.

[Yogagirl123]

DS had allergy tests for wheat, milk and dairy, all came back negative. DS takes Movical Paediatric powders two sachets each morning and 5mls Pico each night. This is his regular dosage since the acute impaction stage, where the doses were massive, he missed over 1 week of school, but it was totally necessary. It is definitely a medical /physical problem, we tried incentives when he was younger, it was soon clear he just couldn't help it at all, DS had no control over it what so ever. Life is so much better for him now and me! Good luck OP I hope things improve very soon.