Chronic constipation 2yo - any advice?

[katechristie]

Obviously this is going to be a TMI post - not for the squeamish

DS is 2.7yo and has been on lactulose for 5 months now. He'd been having 2-3 poos most days, varying in size between a thumb nail and full thumb (mine not his!) fairly solid but softish. Last weekend we gave him a glycerin suppository as felt he was passing overflow again, he had 3 huge poos that day, I've never seen such big poos come out of him, but he hasn't since been all week, apart from little skids tonight. (Should add he's still in nappies, we were starting potty when it all kicked in and there's not been a lot of point pushing it as he strains a few times a day and isn't too interested in the toilet). - Have I made things worse giving the suppository last week?

Now I don't know what to do - I don't want to give another suppository as don't want the bowel to get even worse not working, but even the lactulose hasn't got him going this week. Should we up the lactulose - he's on 10ml a day at present, we were thinking of introducing another shot at bedtime - 5 or 10ml? We try our best with his diet - as well as we can with a fussy toddler, he has weetabix / porridge / shreddies for brek with diluted apple juice (I keep trying with the orange juice as I know that's supposed to be better). He'll have a smoothie most days (only 1/5 banana in it) but will still only suck on other fruit - grapes, orange, satsuma etc.

I try to include veggies (and hide them in spag bol, casseroles, stews etc.) in his food. We've got around 10 different glasses and cups for him now, we buy a different character one each time we're out to try and get more fluids in him, but I still dont' think he drinks enough water.

Please has anybody got any suggestions, I'm getting desperate, it's so distressing. He strains a few times a day "poo mummy" he says, then nothing comes out yet again, even though he's red in the face.

I think I'm going to take himback to GP and ask for a referral to the constipation clinic, but any suggestions in the meantime most welcome. TIA

[BlueBumedFly]

I have a the same issue running on the allergy section as we have the same problem.

We give all fruit/veggies etc and still no joy. I know that Movicol is the next step as I have heard that it has excellent results, retrains the bowel and is non-additive. You have to ask for Movicol by name I though apparently otherwise they just tell you to add more veg and fruit.

I was told not to give cooked carrots or butternut squash - apparently they add to constipation! Carrots are in EVERYTHING I cook as they are easy to hide! Bananas are also binding, maybe cut those out?

I am trying lactose-free milk and no carrots. If that fails I will ask the GP for Movicol.

Its horrid eh? Really painful for everyone, we can have a whole 24 hours of moaning and crying an numerous trips to the loo with no result. It makes me want to cry!

Good luck, speak to the GP about Movicol.

[katechristie]

thanks BBF, yes we've tried not giving the bananas, so he only really gets the ones that are in the smoothies, but they were the one reliable fruit he'd eat! yes, we're a carrot-house here too, again, one reliable veg he'll eat. dam didn't know that or the squash either. It's tough as you try to get their iron in them, fruit & veg etc. nto too much dairy, but still enough calcium. funnily enough I've just ordered lacto-free milk on the tesco shop for him, as wondered if this might help. Will have a look at your thread too, thanks.

HV wants me to get movicol, but I was a bit reluctant with the side effects if it could be sorted with lactulose, but of course I just want it sorted so movicol it is if nothing else works.
thanks again.

[BlueBumedFly]

Good luck, I have spoken to a friend now about movicol and it is designed to retrain the bowel. Make it 'fitter' if you like to aid complete recovery and make it less 'flabby' which is what happens when the bowel is constipated for a long time. It gets fat and flabby and can therefore store more poo, then it gets self perpetuating. Have a google, it does look very beneficial.

[katechristie]

ahh, yes, I read your thread yesterday, just realised
yes, i was sold on the movicol, I just read too much into the side effects - which are obviously very low risk, but sound horrible, but of course, worth it to sort this out as this can be hideous itself. I think DS' bowel must be stretched by now and does need the retraining. At least you've managed to get somewhere with the potty, I feel DS will be in nappies longer than DD at this rate (she's 5mo!). Bless him, think it's getting him down now too. I got some bubbles as the HV told me to sit him on the loo and just let him have them then - the blowing helps the bowel, plus the novelty factor - worth a go! thanks for the reply. Not that I want anybody else's DCs to be going through this, but good to know we're not alone. I've trawled the archives too, but a lot of it is short-term. Feel like I made it worse with the suppository than better as it's cleared him out, but at least he was still going. I don't know if getting it all out is better, or better for the bowel to at least still be working every day pushing smaller amounts out.

[BlueBumedFly]

i know what you mean, you don't want anyone to have a child suffering but it is nice to know we are not alone!

Have also resorted to mini smarties....as a reward of course !

[katechristie]

oh, DS has discovered magazines exist!!! mini smarties would of course be much cheaper, but when he's had a few bouts of pushing, been watching me feeding DD half the day and is a bit fed-up, it's his treat.

[ronshar]

Have you tried giving Apple juice as a drink each day. Apparently it is a good mover off poo. However it may be beyound that now but worth adding to your weaponry.
Good luck.

[BlueBumedFly]

Yup and nope, not a bean of difference

[tattycoram]

My DS had a phase of being extremely constipated and having anal fissures . Movicol sorted it out. I would try cutting out weetabix too, it really blocked him up and even now makes a difference to him.

[BlueBumedFly]

Tattycoram, a question that is TMI for some I know, how do you know if they have anal fissues? I know DD has had one 'split' as I say it right at the back (sorry I said TMI) but it seems to have healed on the outside. How do I know if they are not still there on the inside? She screams pretty darn loudly

[Carmel206]

Have you tried one carton of Aptimel baby formula - or SMA gold a day( the made up stuff in the carton ) not the powder. A health visitor told me to try this a few years ago for DS along with as much water as I could get him to drink ( I also got prune juice and tried to get him to drink that - diluted to make it more palatable)
I stopped giving rice and bought wholewheat pasta - if you put enough sauce on it you can almost disguise the fact that it tastes like cardboard.
Also grate apples - sometimes this makes them more attractive adn raisins are also good.
When he resisted drinking water I mixed his normal milk with water and managed to sneak soem in. Eventaully- it worked! Good luck -

[tattycoram]

I don't know. Our GP had a look and diagnosed it, so I suppose it must have been visible from the outside. It's so horrible to see them in pain isn't it . It did clear up for my ds and he is fine now and I'm sure yours will be too.

[nightcat]

Don't worry about cutting down on milk, nutritionists say that in humans the enzyme digesting milk often stops working beyond approx age 2. You can still give him small amount of dairy in yoghurts or cheese and in all honesty, there is plenty of calcium in leafy veg. For 3 years my ds was in agony over this (inc bleeding bum), until a locum dr who was also working in a nutrition clinic sugeested to remove dairy for a few weeks - I couldn't believe that it was that simple.

[3littlefrogs]

10ml of lactulose a day is a tiny amount TBH.

Dd was on 3 times that amount, plus senna 10ls X 2 daily plus docusate 10mls daily for over a year to sort out her chronic witholding/constipation.

That was a few years ago, and I understand nowadays movicol is the treatment of choice. I would go back to GP, ask for referral and movicol, and be prepared to stick with it for months, if not years. It is worth it in the end because it is an awful condition for a child to cope with - it takes over their lives and prevents them having fun, doing sports etc if it isn't sorted out.

[3littlefrogs]

10 mls NOT 10ls!!!!

[lilymolly]

Movicol is the only thing thay worked for dd.
She has been on it for nearly a year and whilst she still has soft poos everyday, if we stop the movicol even for a day, she gets constipated again.

I asked for a referrl to a constipation clinic at local hospital, following loads of faffing around with senna, and then lactulose and the GP was useless.

I was referred within 2 weeks and we go and see a nurse specialist every 3 months or so, who is wonderful.

DD is now nearly 4 and has had constipation since she had just turned 2 and its still not better- its a very long process to retrain the bowel and also get it back to its pre distended shape.

We are now working with nursery school to get her trained ready to be able to poo in school - and that is a year away -It does take time.

I would heartedly advise you to ask for a referral.

[Pitchounette]

Message withdrawn

[katechristie]

thanks for the extra replies, have only just seen them today, having logged on to ask my new question following on from this now that we have a referral! thanks.