To as you for advice re DS sudden, terrible constipation - desparate!

[justkeeponsmiling]

Posting here for traffic!
So, DS aged 4 has always been a poor drinker, needs lots of encouragement and even then will take in hardly any fluids. Over the last week I have been working shifts and so haven't been able to nag him about drinking as much as I normally would. In addition, he has been off school due to easter hols so hasn't had his regular morning and lunchtime drinks. Add to that a diet which could have been better (easter treats, etc.) and this evening I have found myself in the bathroom with him for about an hour, crying/screaming desparately, trying to pass a huge, hard poo. We tried applying some vaseline to help hik pass it but to no avail.
After getting some advice from an out of hours doctor I have given him some laxative (lactulose) and a glycerine suppository, to no avail. In the end, he was so sweaty and exhausted from all the straining and crying, he just fell asleep and I put him to bed.
I just don't know what to do tomorrow morning! Has anyone been in this situation before? Is there anything I can do for my poor boy to help him, apart from giving him lots of fluids and more lactulose?
Please, please, any help/advice would be so appreciated!

Gosh, poor little guy. Would he eat prunes, or drink prune juice? That can help.

We've had ongoing constipation issues with dd1 for a few years, so I really feel for you and your poor little boy.

I find that the biggest thing that makes a difference with constipation is fluid intake, so keep it high. We started giving dd1 squash rather than just water and it's made a big difference, but I still need to encourage her to drink.

In terms of laxitives, I find movicol is much better than lactulose. It also works by increasing the fluid content of the gut, rather than stimulating the gut (like senna does) which can be painful if you really can't go.

Other things that help are high fibre foods like prunes or apricots and plenty of gentle exercise.

Sorry if this is a bit tmi, but when you ds is trying to poo it helps if his feet are raised up with a step or pile of books so his knees are bend (almost a squatting position) as the muscles work better there. You can also put gentle pressure.on his perenium (between his geninals and anus) which will help the poo to pass.

Thanks for the reply! I was thinking prune juice might help, will pop to the shops first thing in the morning and get some, I think he is so desperate himself he'll be prepared to try just about anything, only just about gritted his teeth when I gave him the suppository

Ds1 was hospitalised with suspected appendicitis which turned out to be constipation. It really can be nasty, poor boy.

Ds1 was prescribed movicol which worked wonders in a day or two x

Could you put a gloved finger up his bottom and help clear a backlog? My son (1) was terribly constipated and the doctor did this to feel for impaction. It seemed to help shift things around and a couple of hours later he managed to go... And go and go and go.

The problem is, is that the poo that is stuck will be hard and almost dry. Anything he eats and drinks now will soften the poos behind it but won't help if he has an impaction. Another suppository in the morning maybe?

So sorry for him, it's awful.

attheend thanks, nothing is tmi, this is exactly the kind of advice I was hoping for! Movicol sounds like an option, definitely worth looking into tomorrow when our regular gp will hopefully be available and happy to prescribe some meds as opposed to just giving me advice and sending me home empty handed

This possibly sounds odd, but would he be able to pass the poo if you let him sit in a deep, warm bath tomorrow? Just tell him the water will help relax him - which it will - and that if he feels things moving, he should "let go" while he's there.

He will be so scared now and dreading the pain, so I'd try anything if were you - easier to clean the bath out than sit there with him straining on the loo for hours, in pain.

Does he get lots of exercise? Because that helps too.

I hope he manages to go soon.

"Bigred" I sort of tried that VERY gently but it was so painful he became hysterical I might try another suppository in the morning, just a bit unsure if I could "overdose" DS? Dr google says not to give a second suppository if the first one doesn't work, not sure why though

Give up using the loo, he'll be much more comfortable in the squat position, put a newspaper or potty under him.

It really does work.........been here far too many times. >

The suppository and lactulose is likely to not work strait away. Lots of hot warm baths and tummy massage anti clockwise from the top of his groin up past his belly button and down agin the other side don't go across under his belly button and start again on the otherwise. So basically massage a square anti clockwise without joining up on the bottom. If that makes sence. Lots of warm fluid and I would try fibogel rather than lactose longer term. It helps to bulk with cyber which softens the stools and helps encourage the natural peristalsis of the bowel. Lactulose will soften the poo and not encourage the bowl to pass the stool out. Hot water bottle on the tummy. Encourage him to pull up his legs maybe let him push his feet of your hands or thighs.

I wouldn't do as other pp suggested and put your finger in his rectum. It's likely to make no difference if he is so impacted. With the lactulose and suppository he is likely to pass runny stools before he passes the blockage. So keep up with the laxative for a couple of dresses after he actually goes as it is likely he may still be constipated. HTH

My advice relates to a younger child, but no idea why it wouldn't apply to your DS, as well.

Warm baths; cycling motion of the legs to get the gut moving; lots of fluids, including some orange jouce; rehydrated, cooled dried apricot as a purée.

Your poor DS and poor you seeing him so distressed.

I hope not too unPC to say this but I think there are similarities with experiences looking after DPs Mum who has dementia. In the past she has been hospitalised due to constipation so we are really vigilant and it is a constant concern for all her carers (not me at the moment as on maternity leave).

On one occasion a warm bath helped a lot. It was comforting and eventually she relaxed enough to open her bowels in the bath.

The knees up position also helps a lot.

She now takes movicol regularly, it has a gentle effect although some carers have over done it a bit with unfortunate results... Currently she is on a regime of a small dose every other day which keeps things moving.

Good luck

The problem with putting anything up the anus is that constipation often goes hand in hand with anal fissures (little tears to the tissue around the anus caused by straining), these can be very painful. If you think your son might have this then he can have calpol, and there's a topical pain relieving gel your gp can prescribe.

Movicol will help saturate the poo in your ds' bowel until the plug softens. The regime we used at dd1's worst stage was to give an extra satchet every day (1 the first day, 2 the second day etc) until they poo.

Young children don't always have the impulse control to let the poo come out, because it hurts, so they hold it in at the last minute and this makes the constipation worse.

The bath suggestion by babyboomer is a good one.

Frozen fruit juice is just a very cold drink presented as an ice lolly.

Poor little chap

Thank you all for the advice/reassurance and handholding! After trying throughout the night, DS finally managed to go this morning. A combination of cold juice, hot water bottle to the tummy, lots of tummy massages and, in the end, squatting whilechectried to go got us there.
A huge thanks to you all

Wonderful! I'm relieved for you both.

Thanks for updating.

Brilliant! One thing that had helped ds with mild constipation is a good run / walk every day. I know it sounds simplistic but its just an extension of the leg cycling for babies . And yy to weak squash to boost fluids.

Good luck for a longer term solution

My four year old had exactly the same problem he is autistic and non verbal poor little thing it was horrible to see him in so much pain he did go after some lactulose once he passed the hard poo he kept on going all day I was just releived he was not in any discomfort!

just

My dd suffered dreadfully when she was about 2/3

We ended up going through DH's medical covet to see a consultant

Although we had been using syrup of figs and lactalose according to the doctors instructions it wasn't working

The consultant said (only half joking) to get a funnel and pour the stuff down her throat and to not pay any attention to the recommended dosage

We had to hold her down (she hated the syrup of figs) but it worked. The next day she did the most explosive poo ever and has been fine since then

I hope it goes all right now

Glad it is sorted.

So glad to read your update, OP. Your ds will be a much happier boy today.