Poo withholding (almost) 4 year old

[littlepiggies]

Hi all, lovely DD has had poo withholding issues for almost a year now. We've been through pretty much everything we can think of: sticker charts, reading books, focus on diet, regular toilet times, encouraging her to do it wherever she wants (even knickers) so long as she goes, going back to pull ups and then back to knickers again, massage, lactulose......Has anyone got any ideas? We've been to the health visitor (completely useless - just wanted to talk about how difficult it must be for me -huh?!!!) and GP quite a number of times and they are reluctant to prescribe anything stronger than lactulose which frankly seems to have no effect. I am pretty much at a loss so before I barge into the surgery demanding movicol and / or a referral to someone who might have some better ideas does anyone have a genius tip that might solve poor DD's poo problems?

[Egg]

Movicol worked wonders for my ds1 who had serious withholding problems. After 8 months of it i have finally weaned him off it and he is pooing ON THE LOO regularly!

The movicol worked within a day or two to get things moving and the difference in him was amazing. He became a happy lively boy again. We had no problems getting prescribed movicol thankfully. I told gp he was withholding for up to 5 days at a time and was eating less and less and when he finally did poo it was agony for him.

If you search mumsnet for the word movicol you will find lots of threads and maybe get some advice on how to approach the gp.

[KembleTwins]

You have my sympathies! Had problems with DT1 (ongoing but kind of sorted ish) and got movicol from dr - no problems having it prescribed. It got her going within 3 days, and doing a poo without it hurting massively was a huge relief to all of us. Her confidence had been knocked though, which is why it's still on-going - I have to go with her and reassure her it's not going to hurt.

When I called GP about it, I specifically requested movicol as it had been recommeded on MN. GP wrote prescription without actually seeing DT1 but I was so grateful I didn't make a fuss!

[blametheparents]

My DD is on Movicol too.
She now has 1 sachet a day which seems to keep her regular. I also try as har as I can to make sure she drinks enough and has enough soluble fibre a day.
She is starting school in Sept, and I would like to keep her on the Movicol until at leat Xmas so that we can get over the starting school hurdle, before tackling the pooing hurdle! Luckily my GP is ok with this and has just given her a repeat prescription.

[littlepiggies]

Hi all - thank you so much for your responses. I'm pretty sure her bum is a pile-free zone but I haven't checked recently so probably a good idea to have another look. I'm glad you have all had success with movicol - looks like that may well be the route to go down. Back to the GP!

[muumi]

Hi All,

I am so relieved to see these posts about Movicol (why didn't I look sooner??). My DS has been withholding for a year now and has been on Movicol since October. It has been brilliant to get him pooing (he too was withholding for 5 days and not eating, really upset all the time etc.)but he can still go for 3 days at a time without going even when on quite a large dose. To top it off he prolapsed the other day which was very scary, although the GP said quite common in children with this problem.

Egg, that is really reassuring that you got him off the Movicol with such great success. Can I ask how slowly you lowered the dose? I'm really concerned that potty training has to start soon and until this is all sorted out it's never going to happen.

Littlepiggies, I don't know where you live but we found a great consultant at the Whittington Hospital in North London who really helped. His name was Dr Broadhurst - your GP could refer you - and he was so reassuring.

[littlepiggies]

Hi Muumi, we're in sarf London but used to live in Crouch End so well acquainted with the Whittington & wouldn't be averse to crossing the river at all. We have a GP appointment next Tuesday so will discuss the options with her then and it's great to have a recommendation

[muumi]

Excellent. Good luck with it.
I have also recently taken him to see a homoeopath who has been great and amazingly after each remedy that she has given him, he has pooed almost with no problem. (although then gone back to withholding). She is seeing him again tomorrow though so I'm hopeful that that might make more of a change over time.

We had a horrible episode at the weekend where DS bottom prolapsed which was really scary. I hope this all gets sorted soon as it's so horrible for him, and for us. I really know what you're going through.

[Egg]

muumi I kind of didn't really "wean" DS1 off the Movicol in the end. He threw up a couple of times about 3 weeks ago and I stopped giving it to him until his stomach was settled again, but as he was still managing to poo without any issues I actually never gave it to him again! I was delighted as have been having visions of him being on it forever. I had tried to cut it out before but he had always gone back to struggling a bit. He was only on one sachet every 1.5 days though so never a huge dose.

Coincidentally (or not) this happened at the same time he finally stopped pooing his pants all the time . He has been out of nappies since April and was weeing on potty and loo within a day or two without problems, but has pooed his pants regularly ever since. I was at my wits end as he had sometimes managed to go to the loo and poo without a problem but he would often do it in his pants three times a day, and never a huge amount (but it didn't look like the overflow soiling he had experienced pre Movicol). Anyway we tried everything and nothing worked, rewards, punishments, star charts, me sobbing , but once he was off the Movicol he hasn't pooed his pants once, so I wonder if it was stopping him having enough control (poor lad).

He is a happy and proud boy now .

[Kittle]

Muumi, I just saw you mentioned being referred to a hospital consultant. Could I please ask - was this something your GP suggested or did you have to push for it (I'll have no problem doing that )

My son withholds for a week or more. It's terrible. He's been on Movicol which helped a tiny bit but stupidly we didn't renew the prescription in time (getting more today, phew) - for the past 4 days he's been on Lactulose/Sennakot instead, but they just don't seem to work and the senna gives him pains.

We're struggling to get the dose right. Too much = nasty leaking and he STILL withholds. Too little...well, we'd be back to square one I suppose. It's awful. Plus it's psychological anyway, all caused by fear, which makes we wonder if we need more than laxatives. GPs are so casual about it. Meanwhile we're in hell. Got a sick cat too. Had enough

[thesunshinesbrightly]

i know how everyone feels, it is awful stressful for us and the children, we have been through all the charts, rewards blah blah blah,

doctors, hospitals, head doctors my child hasnt had any tests done as they think it is all in his head!!

he is now 13 and had no signs of ever going on the loo!!!

dont want to put you off, just wanted to let you know its not abnormal and you are not alone.

[alypaly]

try not to even talk about it in front a your child as it becomes a psycological issue.if the poo has become impacted movicol is the best. If they have an rectal tear internally then lactulose used regularly will softe everything up and make it easier to pass without re tearing. if you want to speed things up then junior syrup of figs...stand back and light blue touch paper

[lilacgirl]

Great to read that someone else has the problems my dd2 is having - well, not great that others are suffering, but good to know that we are not alone! She must by now have a phobia of pooing as she stops herself - she is currently in pain cause she won't go. I'm on computer cause she always sends me away (in case anyone thinks I'm uncaring!). Doc prescribed Lactulose and plenty of fluid. She doesn't eat much when like this so all she takes in is Orange Juice - which is sposed to be good for pooing isn't it? Will have to try Movicol (if doc will prescribe) and see what happens. She has even had suppositories, which get the poo out but she still thinks it will hurt when she does it.

[trace2]

just found this thread my dd is 2 and got hold of ds cheese and onion crisps she is allergic to milk and makes her constipated with it and with holding as it hurts her to much i gave her marvical tonight but she crying inpain how long befor i go back to gp?

[ballynacargy]

Encourging to see so many with same issues on withholding, to get the dose right seems the tricker thing about it, if poo too loose, soiling constantly, too hard and obviously withholding, pain etc. Flaxseed oil does seem to help in conjunction with movicol, my dd incontinence nurse recommends up to 10 ml at bedtime and sometimes it does appear to prevent my child withholding, in tat the poo just comes out - which has its drawbacks right but hey its out... Where can I get junior syrup of figs? Boots no longer stock it at my branch. Best of luck all..

[wolveschick]

We have now been going through this for nearly 2 years with DD2 who is nearly 4. Can I recommend the ERIC website and helpline which helped me out no end.

Following a nasty bout of chickenpox where a lot of spots were in her nappy area she refused to sit down in the bath for 6 months after the spots had made it hurt and we think that this is when her witholding problems started.

Luckily my GP was supportive but they dont have the time to explain everything properly.

DD2 was prescibed docusol-she needed more tthan lactulose which did not have much effect.

She has now been going to the toilet properly with not a single accident for 4 weeks (coounting every day!).

I did the following

1. Reflexology and massage once a week (this had an effect within hours) and relaxed her no end. She LOVED this-luckily it was with someone she knew.

1. Sticker chart for just sitting on the toilet with no pressure to perform (as sitting on the loo was becoming a real issue for her)

1. 5ml of docusol 3 times a day

1. A book that the ERIC website recommended-by Dr Cohn. Amazon sell it. Worth EVERY penny as it explains everything brilliantly and you do not feel so alone.

1. A call to the ERIC helpline.

1. I did look at the fibre chart in the book but she had a good diet anyway but it made me more aware of good things to give her

After a few weeks of this suddenly she announced that she was going to try to poo on the loo and did. She has done ever since.

What the website and my GP have said is that you will need to keep on with the laxatives for a LONG time-suggested a year after she has got better. As hers was, I think a psychological problem you have got to avoid her getting constipated/sore again so that she does not start witholding again

Hope this helps-just one thing, although the ERIC site is fantastic I would avoid the forums. It wasnt what I needed to read (I was fairly close to breaking point when I found the site) to read about much older children with similar problems. I needed some hope and this just panicked me more.

[wolveschick]

The book is 'constipation, witholding and your child-a family guide to soiling and wetting by Dr Anthony Cohn. 9.49 from amazon at time of typing.

DD2 was going for a poo once every 3 months on average, the reflexology and massage made it a weekly event for a few weeks, now it is a daily event.

Hope this all helps