severe constipation still at 18 months and no further with docs any advise

[NessaWH123]

Hi I am looking for any words of wisdom as the doctors and consultants are useless. My son was born 4 weeks early by planned c section as I had vasa praviea and since then he has always had bowels complaints. When he was younger he had many episodes of diarrhoea and passing mucus and was told he might be dairy intolerant. He was on medicated milk until the age of 12 months and we controlled his diet to be dairy free .As he moved to solid foods he then became very constipated and has done ever since. Sometimes the chronic constipation can result in us having to use suppositories. He is often sick from all the straining on a very bad day and is quite tired. He doesn't have a big appetite and no appetite at all when badly constipated. He strains and cries a lot when trying to poo and often he efforts can go on all day with no results. He has now been told to up to 10ml of lactouse twice a day which have done for 6 months but he still has very bad episodes built up every few weeks. We have read about hirschsprungs disease as it was vaguely mentioned by the doctor on our many visits to ask advise. Any ideas would be grateful? Thanks

Would ask to try movical, I think it is now first line treatment for constipation according to NICE. How old is DS? My DN was put on movical as a toddler and it really eased things for her. HTH.

Thanks idefix he is 18 months now. The problem with movical is the amount of liquid you have to get them to take. Tried it before but cant get him to drink the amount of liquid required...how did you manage it.

DSis used to pop it in a spouty cup and it was just a "drink" she used to get the plain one and flavour it with cordial - I know not everyone's a fan but it worked for her. DN was allowed to drink it as and when but it was the only drink she had till it was gone, this bit by bit intake did not seem to diminish the effect.
Is DS still dairy free? What sorts of things does he eat? :)

Is your son under a gastro consultant? If not, he should be. Hirschprung's should be ruled out rather than mentioned all the time.

Also: Lactulose is no good for chronic constipation. It really isn't. My daughter (3) and I both suffer, and Movicol is the best and most effective thing for both of us. I know it's hard to get them to drink it, because it doesn't taste nice, but you need to persevere.

One thing to bear is mind is you don't HAVE to mix each sachet in 60ml of water. You can get away with using a little less, just to get it over with quicker. Also consider giving it first thing in the morning when he's thirsty - that's what I do, and it made a difference. I take it you've also tried masking the taste with squash instead of mixing in plain water?

As he was born by cs, his gut flora will already be compromised. If it were me I'd go and see a natropath and get a good programme in place to heal his gut and promote the development of a healthy micro biome.
It's worth getting a recommendation for a really good one in your area.

In the interim you can get him on a really good probiotic, start making chicken bone broth and add some good grass-fed gelatine to his diet.

That all sounds a bit woo to me, Surfsup. My DD was born naturally and her bowels have always been awful.

This poor little boy is so badly constipated he strains until he vomits. I don't think "a healthy micro biome" (whatever that is) can shift a bowel impaction - which this little boy undoubtedly has.

Alternative therapies are all well and good, if that's what you want to spend your money on, but never at the expense of actual medical treatment.

Thanks idefix he isn't dairy free at the mo as I didn't see any improvements so decided to give him dairy so he was getting calcium and he will actually happily drink cows milk where as on the medicated milk he basically refused it . I will def try again with movical with yr ideas and your ideas thanks diving off the balcony. Thanks for your advice. Just find as he still doesn't really communicate well its difficult t explain how he needs t drink it. Thanks for your input surfs up but I'm with divibg off the balcony sorry and think I need a more medical approach esp with the sickness from it and the constant pain he is in. I have an appointment in November after waiting since April to speak t the consultant again so see if any further forward then and yes I def want them t check for hirschsprungs and not just discuss it sick of asking them t help xx

I'm not talking about alternative therapies at all! This is very much accepted medical science. Obviously you need to treat the bowel impaction to alleviate the symptoms, but laxatives can't help improve the gut health which can be a major cause of constipation.

Have a look at this programme if you think I'm getting all witch -doctory on you.

The reason I recommend a natropath rather than an ordinary doctor is that they have been promoting this issue for a long time, whereas the medical profession is only just waking up to the realisation that they were actually on to something, so natropaths (and yes some of them are quite woo, which is why you need to find a really good one, preferably with a medical background) are often better informed about effective treatments.

BTW, the microbiome is the bacterial population of the human gut. Plenty of naturally birthed people have issues with gut health and the many issues that it can relate to, but babies born by cs are generally more effected.

NessaWH123, I am sure you you know this but just thought I would put it out there that if DS is fond of milk, yogurts, cheese etc these can make you quite constipated if they form the bulk of diets.
Interestingly my DDs paediatrician recommended probiotics, DD has a diagnosis of oral food allergy and Ehler Danlos type 3. Both of which can affect bowel habits, luckily never had a problem with constipation, mainly I think because she has such a health appetite...I was a bit surprised by the suggestion and I come from a medical background.
Have you considered asking for a referral to a dietician? It might be useful to have a fresh pair of eyes/mind looking at what is/is not going in.
Hope you have a better day today with DS.

improving gut health is not woo, it's a major area of research and interestingly allergies may be curable that way although it will need a lot more research. When my, now adult, child is home I feed them live yoghurt every day.

Dehydration is a major source of constipation so get liquid into them any way you can.

Hi OP,

In my experience, the reaction to dairy can change with age.

My eldest was diagnosed at a very young age as dairy intolerant. He was breastfed at the time, and at 3 days of age the screaming started thankfully a midwife friend suggested giving up dairy, and the screaming stopped. I continued to breastfeed and supplemented with Nutramigen.

Unfortunately we received pretty cruddy advice from a paediatrician (who DS later saw for reflux), and we were told to periodically trial him on dairy to see if he had outgrown the intolerance

Initially, at about 9 mo of age, he seemed to tolerate dairy - but after some weeks of having dairy (yoghurt) daily, I noticed he was becoming increasingly constipated. I stopped the dairy for a while, and his constipation resolved. When I retried it a few months later, the constipation returned, this time accompanied by a nappy rash.

I know it will probably be difficult (my 25 month old hasn't had yoghurt for at least 6 months, but still remembers it and asks for it), but could you try cutting out dairy for a couple of weeks and see if the constipation improves? It may at least give you something (else) to tell the consultant when you are seen in clinic, irrespective of the result you get, and may save you time, in terms of getting things sorted for your little man.

A lot of people (including babies ) are intolerant to wheat especially wholemeal wheat. I always used to get constp. with it. As soon as I cut out all wheat I got better.