Toddler severe sore bottom

[Mummyneedsadvice]

Hi, I’m new to this and have read some posts from over 8 years ago on a similar issue but feel there might be some more relevant advice out there from you lovely people. My 3year old started with constipation 3 weeks ago just after his 3rd birthday which we got past using movicol. What he is struggling with now is a red raw bottom which is hurting him when he needs to go. We had a spell of him having accidents (he’s been potty trained for about 4 months) which again we’ve got over however he’s now associated the pain with the toilet and is refusing to go on the toilet when he needs a poo. The last 3 days have been extremely distressing as small amounts of poo are passing but he’s holding it so it’s making his bottom worse. Trying to clean him is impossible he is literally screaming and resisting as much as possible. I’ve tried sudocrem, metanium, savalon and Vaseline (all on different days of course) but nothing is easing it, metanium used to sort any nappy type rash straight away for him. I’m trying my best not to wipe and he’s been having baths throughout the day. It’s happeneing now every half an hour and he is exhausted from the upset. I’ve been to the doctors twice and the most recent time she prescribed caneston however that was 2 days ago and it seems to be getting worse not better. She advised me to give him about 4 sachets of movicol a day but I feel until his skin heals forcing more laxatives on him will make it worse (I am following the docs advice at the moment though). Ive stopped him having milk, bananas and yoghurts in case they are adding to the problem. He doesn’t seem to be peeing as much as usual in this last 2 days but wonder if this is because he’s using so much energy when he’s resisting. I’ve also tried salt in the bath and would welcome any further advice as I really am heartbroken for him. Could it be something more serious? I’m worried. Thank you

Is his sore from diarrhoea and the subsequent wiping?

Bepanthen is much softer and kinder than metanium which is very drying.

That's not to say it's so soft as to be pointless, it's a brilliant cream and it used to be recommended to put on after tattoos to aid healing. My friend swears by Lanolin which is the nipple cream as well.

I'd make a docs appointment in the morning, perhaps a steroid cream might be needed if it is as bad. Try not to wipe too much, use water and cotton wool and be really gentle.

We bought my son the book "It Hurts When I Poo" book when he started withholding, we found it really useful and did whatever we could to keep him sat comfortable on the toilet for a long time to help his bowels naturally want to poo (eg - let him play phone games!)

Is it the skin that is hurting or the pooing or both?

I think it is both so I’m trying to avoid wiping and showering him down or bathing him in the bath but it’s difficult to do when he clenches so tightly

Wipsglitter I think it’s the sore bottom more that his tummy he seems terrified of letting himself go so he’s holding it but there are small bits coming out then making the sore worse

Politicalbiscuit thank you for the book recommendation I will order that now! I’ve also tried bephantham but not the nipple cream so might give that a try. The Caneston that the doc prescribed is a steroid but you can only use that twice a day, we are having to clean him every half an hour at the moment.
Thank you all for your help so far

My son was given numbing cream for a similar issue, that and some simple Vaseline sorted it out

Thanks Bert, was the numbing cream prescribed or did you buy it at a chemist? That sounds like it would help

My lo is 3 and we have had poo withholding. Its been horrible. We've taken a step back for the moment. They ask for a pull up for a poo and pants/potty the rest of the time. We are just getting back to a poo a day and no constipation so will try "poo training" again soon.

Try Orabase. A chemist should be able to order it if they don't stock it.

Cleared my babies weeping bottom super quickly as it absorbs liquids keeping them away from the skin. It's miraculous.

Glitter, yes we’ve debated going back to a nappy for the poo’s But it seems to be coming over him in waves every half an hour so I fear he would get used to being back in a nappy. Good luck with your lo sounds like you are almost on the other side

Thehousethat thank you I’ve not heard of this before so will try and get some tomorrow, I’m willing to try anything!

It was prescribed, not sure if it needed to be though

Honestly, if nappies help then go for it. If that means another stab at training later, so be it.

Smother the area with Vaseline or similar very soft cream constantly. Then when you need to clean him, it will be much easier- don't really need to touch the skin at all, just the superficial cream.

Once he's actually poohed, try and let him be bare bottomed as much as possible. The fresh air and light really help.

If he's very constipated you might need a stool softener to help things along. It SO stressful. The day I resorted to a suppository for DS1 is burned in my mind...

Would something like anusol (haemorrhoid cream) help numb it?
Poor little boy (and poor parents too!)

Also, how about applying a thick layer of cream to his pants, so you don't need to touch him to apply it?

Is he impacted? Are the bits that are coming out diarrohea that have got passed the impact ion?

The metanium you're using, is it the one in the yellow tube? (the one in the yellow tube is the only one worth its salt). If it is the yellow one get the GP to prescribe you something.

Go back to the GP and ask for laxido not movicol. Movicol is horrible, the laxido tastes much better. Give him plenty of "P" foods... Prunes, pears, peaches aPricots and avoid the "ABCs"... Apples, banana, carrots. Make sure he is having some fibre regularly and drinking lots.

Get in touch with your health visitor, explain the situation and they should be able to refer you to a the paediatric continence nurse. We used wipes to wipe his bum rather than tissue as it felt less rough for him.

My son withheld and was constipated for about 18months, he ended up on regular suppositories. It was a total nightmare and he was in pain a lot of the time. In all honesty though the main thing that got him through it was time. We tried everything but eventually everything just came together and it clicked for him when he was 4. It is incredibly frustrating for everybody!

I will say the best bit of advice the continence nurse gave us was to put him back him nappies for a while and forget about it. Once the pain and withholding had gone away for a bit she said tell him he is allowed to use his nappy as normal but it has to be whilst stood in the bathroom... Once he had mastered that then it was stood nearer to the toilet... Then touching the toilet... Then sat on the toilet with nappy on (you get the idea). This took months and months but it did make him more comfortable around the loo. But overall I would say don't be afraid to back off on the potty training. The continence nurse told us she had never had a neuro typical child not get past this problem it just takes a lot of time and patience.

Hope this helps :)

And to echo above read about the symptoms of impaction to check its not that.

Thank you Catlass, gosh poor you I don’t know how you coped for 18months, I’m falling apart after 3 weeks. Yes we’ve got the yellow metanium. Hadn’t thought of the health visitor though will give them a try. Thank you and let’s hope it’s not going to be much longer for us 🤞🏼

I don’t think it’s impaction as the doc checked his tummy and it was soft. He is managing to pass quite a large stool once a day (mainly in the bath at the moment). I’m giving the laxatives a break today to try and give the skin some time to heal then will start them again when we get some ease

Postit hadn’t thought of anusol just checked the label and it says not suitable for children so I’ve just put a tiny bit on the outside not internal, hopefully that helps with the irritation.

Thank you all so much for your advice ☺️