Hi, my dd is being treated for constipation. It is not a case that she goes infrequently, just that her poo is always very hard and causes her a lot of distress. We tried managing it with diet but it didn't help. The doctor prescribed lactulose which made her worse so he changed her to Movicol. We have only given her a couple of doses and are already seeing good results. Does anyone know if this indicates what her problem in based on the difference in medication? I'm not clear on the difference myself but I think the doctor said the Movicol brings water to the bowel? Is that correct? She has always been a good drinker though so don't think she was dehydrated.
Lactulose and Movicol both work as osmotic laxatives - ie they both keep water in the stools. This means they will be bulkier and softer regardless of the cause of the constipation.
We had real problems with our dd's poos for 18months! Than god she is OK now at 3 1/2yrs. I'm sure she'd get into viscous cycles where she would have one painful / scary one and then be too scared to get when she needed to so would wait until it became difficult. Lactulose and bribery worked in the end for us.
We had a thread about this recently on here as I'm going through the same thing. DS (13 months now) has been like this for quite some time. Initially we, like you, worked on his diet. Then when that didn't produce any improvement we started seeing a consultant who gave him lactulose and movicol. These did produce some improvement but nothing that we felt was fixing the problem. Someone on the previous thread mentioned the possibility that it could be the formula having too much iron in it that was upsetting him so a couple of weeks ago we moved to cows' milk. We were on holiday in Spain at the time and the result was amazing, however the Saturday we flew home we had to use formula and he then struggled again and after a very traumatic movement on Sunday night he didn't go again until Friday after the consultant told me to up his movicol dose. He believes that once this current 'blockage' is clear he'll gradually get better. I've also taken a recommendatino to see a baby osteopath who did find some tightness in his body and also when working on his head said that his system seemed sluggish... I don't have the answer just wanted to share that it is seemingly a very common problem with a myriad of mysterious causes but that it's very rarely anything too untoward and will right itself eventually. Not that this helps how our poor children obviously feel at the time...
When ds1 was little he had problems with very hard poo. One thing that helped a lot was to reduce the amount of red meat he ate. Perhaps it was the amount of iron which affected him, because liver bunged him up dreadfully.
Something else that helps is to give the child olive oil, about 1 - 2 teaspoonsful spread out over the day. Uncooked, if possible, mixed into their food.
If the actual passage of the poo is causing your dd distress, you could try gently massaging a little margarine into her anus just before she poos. I know this sounds weird, but it does help. I was given this tip by a geriatrics nurse.
Thanks for the replies. I must have got the wrong impression as I thought the lactulose and Movicol worked in different ways. No nearer to knowing what the problem is so. The point about iron is interesting but dd has a small appetite so only eats red meat in tiny quantities. She has asthma, eczema and an egg allergy and the paediatrician thinks it might be a good idea to have her allergy tests re-done to see if anything shows up now. Maybe she has a problem with a specific food. Glad to hear your little ones are doing better. It is so distressing for them.