to go to A&e with my dd3 *pictures*

[littlemaemae]

My DD who is 3 has been having stomach/bowel problems for the last year. Diagnose as constipation. She can not pass a stool for weeks despite fantastic diet and laxatives and weeks is in severe pain most days. She is very petite and skinny but her stomach has swollen to look 9 months pregnant. Getting no where with doctors/hospital etc.
Aibu to think this is not how a heathy child's stomach should look.

It sounds as though the PND is clouding the issue with the GP who thinks you're a neurotic mother. You aren't This is serious and people have been giving excellent advice. But I wanted to reassure you no matter what your back story of PND your 3 year old has a severe issue which you are right to not be fobbed off about. I second the advice about keeping all the Movicol packets over a week to show the GP/A&E/continence nurse or whoever you see.

What's the worst that could happen if you went to A&E? Why not go?

This! What if there is an underlying more serious cause? What if there is long-term damage because you kept getting fobbed off and your DD didn't receive the right treatment soon enough? You would never forgive yourself!

FFS, OP, TAKE HER TO A&E!!!

I'm horrified at the treatment your dd has received. Poor girl.

You wouldn't let a dog suffer like this.

Would you consider A&E tonight? It must be so hard to know what to do for the best.

OP i hope your little one is now in bed resting.

to all the posters saying take to A&E .....little one has now been seen by 3 different GPs, and the continence nurse. She has been started on a routine of meds to try and get soften the stool to pass it gently over the next few days. If at any point admission to hospital was indicated any of those 4 professionals could have sent the little one to the children's ward by-passing A&E altogether.....A&E is not the be-all-and-end-all.

hopefully now little one will start to poo!
without manual evac or suppositories - which would be invasive for her, and probably inappropriate if she does have a small anus, and would only clear the rectum not the colon if she is indeed full up to her ribs.

yes an x-ray may well be helpful, but the continence can order this without A&E if she feels it necessary. hopefully her supervisor will contact OP tomorrow and order the required tests/x-rays/scans, and this little one will have the help she needs. it is obvious it is a severe case of constipation, but sadly lots of children in our communities suffer like this taking movicol etc without being told go to A&E.

the primary care teams are there for support - and the phone call in the morning from the continence team as planned should be the next port of call...not an overstretched A&E department trying to help someone by-pass the system.

(unless of course an emergency occurs in the meantime).

op If you can't bear the A&E get some one else to. Could you ask a grandparent a good friend ect..

A very good friend of mine was treated like a hysterical, neurotic mother when she was insisting her dd was ill. She had to go sit in another hospital and refuse to leave after being fobbed off by her local one,GP and health visitor. They actually blamed my friends behavour as being OTT as her first child was quite ill when born.

The second hospital found out she was actually very poorly.

Dig deep and put your anxiety aside and get her for that X-ray.

I think the meds your dd has been put on by the nurse will a actually make things worse.
Many posters have posted about why movicol with work.for yourdd at this stage.
You are not a neurotic mother. She has an impaction up to her ribs. I repeat...they would not leave an adult this long.

This is outrageous

She is in bed asleep she's exhausted.

Boston I am of the same opinion tonight, as I will be contacted in the morning and I have the Senna to pick up from gp surgery.
She has never had a stimulant before so I am hoping this will be a wake up call to her bowels.
if things change or she wakes up in pain I will take her of course. But as she is asleep and comfortable now I don't want to disturb her

Oh no!
That bloody arsehole of a GP. Has he got power issues or something? Dickhead.
Try the hot water bottle, and if she'll let you, about an inch above her belly button, firm but gentle strokes from left (her right) to right.
When they say she's impacted up to get ribs, the transverse colon actually sits not far below there anyway which is where the poo will be trapped. Your large bowel is essentially a lower case 'n' shape. Gentle pressure in the right direction may help shove things along.
I hope you're feeling a little bit better in yourself now.
I understand that you don't feel strong with regards to A&E etc, but do you have a close rough friend who would accompany you and act as an advocate for you and DD?

Do you know the name of the gastro consultant? It may be worth giving his secretary a ring in the morning if you choose not to go in tonight.
They literally are the cogs in the wheels that keep the whole machine working medical secs
They are generally very helpful and knowledgable about different pathways and referrals, and may be able to offer some constructive advice.
So sorry this is unresolved

Isn't Senna that over the counter everyday stuff???

Yes it is Well

I do wonder how many people responding are medically trained.

Dear OP if you do get more worried or your DD symptoms change you can always phone A&E and ask to speak to a Doctor for advice. I've done this before and used the NHS line where I had excellent advice from a lovely doctor who rang back later to check on me because he knew I was on my own. It was reassuring and he told me at what point I should call an ambulance (because obviously I couldn't drive myself) and go to A& E. Luckily I didn't need to in the end. I think if you feel unsure then phone first it also would give them time to get a Ped. Consultant. At the end of the day listen to you own instinct mum's intuition is usually right so have confidence.try to get a bit of sleep or at least rest on the bed.
Poor wee mite. I had lots of investigation. It was found I have dairy allergy. GP was quite sheepish and said he hadn't thought of that. He was most apologetic but at least he did investigate. I would look on the Internet for a new GP as you will have lost all faith in your own. There are some in our practice that I won't see.
I hope it is sorted out soon.

Hi OP, I have been reading this thread with horror. My DS has had constipation and it was awful, but not in the league your poor DD has. I really hope you complain and bring to light what appears to be being fobbed off, repeatedly. Its very different situations, but I have had experience of not being taken seriously by GP's of things that have subsequently been discovered as very dangerous and, in one case (not me personally) terminal. I realise they do a very good job in some areas but, and sorry for any GP's here, I do think that they can sometimes be a bit too 'G' and hence slow to spot something serious or make a referral.
I hope your DD starts to get more comfortable too, and you get the answers you so badly need. Virtual hand holding in your direction xxx

My DD1 had this at the same age and I did LOADS of research. Obviously I'm at an advantage because i know with the benefit of hindsight that there wasn't a serious issue but I just wanted to say that it doesn't have to be something serious.

With the benefit of the retrospectoscope it all started with an episode of constipation which gave her an anal fissure, It as too painful to poo so she held on. She had stool softeners but just got overflow, only stimulants like senna ( and in the end fortuitously an episode of norovirus) broke the cycle.

She's 18 now and has been well for 14 years. Hope all goes well for your DD too :)

Hi op. I haven't read all the responses but just wanted to respond to your question about hospitals in South Yorkshire and to recommend Sheffield Children's Hospital. Both my sons have been there (one at a+e and one admitted) and all the staff (without exception) were lovely.

If that was for me Ditsy4 then yes

Her poor little tummy looks exactly like a friend's son who has Hirshprungs disease. He has movicol between 2 and 4 times a day and has been admitted to hospital on a number of occasions to have Botox injections into his bowel to get things going.

Hope you get some answers soon- I think you have been treated very poorly by your GP.

I'm absolutely horrified at your DD's treatment op, severe constipation and impaction to this degree is absolutely a medical emergency. My DD has a disability that means her bowels pretty much don't work, she's now 15 so we've had many many years of bowel problems, including many A+E admissions for acute severe constipation. It has never been treated as anything other than the emergency it is, the rate at which a little one can get dangerously dehydrated when this constipated is scary, please please keep a v close eye one her, if her eyes get sunken or dark at all get her into the hospital.
From the sounds of her current condition i'd be taking her to A+E and demanding immediate emergency treatment for the severe impaction, in our case this has led to admissions for both manual evacuation and enema and suppository treatments depending on severity. And once admitted I wouldn't leave before seeing a specialist.
I understand you're having a difficult time dealing with it, and dealing with dismissive and unhelpful medics is utterly emotionally exhausting but your DD needs this, trust me the hospital have what she needs to get better fast. The current 'help' you're getting will leave her Ill for a long time before having any effect. If she's comfortable for now let her sleep keep an eye on her condition and seriously don't wait around for people to contact you or give you utterly useless prescriptions (Senna is a complete waste of time now) just get into a+e before it gets busy in the morning and refuse to move until they help her!

You must be so exhausted and worried, and your poor poor DD :( please keep looking for someone to help you!

Sounds like you need to do a round of disimpaction with the movicol, dd was referred to a gastro and this is what we had to do, up her a sachet every other day, my daughter was under 2 and I was allowed to go up 8 sachets, this should get the blockage moving straight away

Poor little thing. GP needs a kick up the arse.

OP

here are the NICE guideline for you to read - they are following them in a fashion....i would guess your consultant has said your little girl has constipation with no cause if he has not order tests when you met him.
www.nice.org.uk/guidance/cg99/documents/constipation-in-children-alghorithm2

movicol as an escalating dose is advised for 1 week....then review
add in a stimulant - senna is a stimulant - so you have been given that on day 1, so you are being taken seriously OP
as osmosic laxative eg lactulose can then be added - which iirc you have already been offered?

so it does seem you are being offered the appropriate treatment according to the NICE guidelines - it is just frustrating that in constipation it is not a quick fix, often a week then review.

the guidelines say NO
rectal meds until oral meds have failed
sodium citrate enemas until oral meds have failed
phosphate enemas unless inpatient in hospital and oral meds + sodium citrate enemas have failed
manual evac unless under anesthetic - and all other options failed.

so it is at least 1 week until review to give the oral meds a chance to work. there is a protocol, and it is best followed at home usually - the continence nurse is there to help you.

good luck OP, i wish your little one well.

Thinking about you Littlemaemae and your poor dd.
Hope she is better very soon X

Really sorry to hear about the nightmare you are going through at the moment,

Just to say keep going with the movicol put it with whatever she will drink, and get as much drink into her even without the movicol.

Dd1 had constipation ( nothing like the impacation your dd has) she took weeks of high dose movicol to get her moving properly. But months and months of slowly allowing her bowel to return to normal. Once the bowel has been stretched it takes a very very long time to return to it's previous elasticity ( 4-6 months easily) do not expect quick fix solutions. Whilst you could go to a&e for a enemas and manual evacuation, these are unpleasant treatments that are unlikely to be offered in the short term to your daughter as nice recommend movicol dis impacation . ( which is much nicer to do at home than in a hospital.

Dd2 has distal intestinal obstruction syndrome ( related to another medical condition) and she has had alsorts of methods of dis impacation, none of which are particularly pleasant. Which your daughter is tolerating the movicol keep on keeping on. I thoroughly recommend the ERIC website is has a huge amount of information on it.

Above all good luck and may the poo fairy visit soon

Just lending virtual support. Poor you and I really hope your DD gets better soon.