URGENT child constipation

[frostedviolets]

For traffic.

I am of course going to call GP but they always take ages to respond.
In the meantime I am hoping I may get additional help on here...

Or is 111 necessary?

My DS (11) is really constipated.
He’s been trying to ‘go’ for over an hour and can’t except for a tiny bit of diarrhoea.
He’s in a lot of pain and a bit nauseous with the pain.
Have given 1 movicol, I know he can have 4 but don’t know if it’s safe to do 4 in one go.
I am assuming it has to be spaced and plan to give another sachet in a couple of hours.
Currently sitting in a warm bath.

Is there anything I can do for him in the mean time?

I am worried about impaction?

I'd ring 111

Calling...

How long since he had a successful bowel movement?

When was the last time he went?

You could go and get some glycerin suppositories. That will soften the hard poo thats causing the blockage. Movicol does take a little while to work!

Says he went three days ago.
Called 111 and GP, waiting on a call back

Definitely glycerin suppositories. Don’t know what age they can have adult ones, the pharmacist will know obviously. Adult ones are available to buy, child ones are only on prescription. I’d give him another Movicol today as well, then 2 tomorrow as well. He also needs to drink lots of water.
Poor kid, it’s bloody horrible, it was by far my worst pregnancy symptom.

For long term help,look on the ERIC website for advice regarding childhood bowel health.

Make sure he stays hydrated with water and don't feed him sugar free squash as it can agitate the bowel.

It sounds like he probably is impacted if he’s having diarrhoea. The ERIC website is brilliant and has a “guide to disimpaction” PDF to tell you exactly what to do. They also have a helpline you could call.

How old is your son? If under 5 then try your Health Visitor straight away. My son suffered terribly with this age 4-6 years and the thing that changed it for us in the long term was the Paediatric Continence Team. HV referral, GP didn't know about them. Movicol should've used consistently on a sliding scale for effective management. You can add it to just about anything- we had to use thick choc milkshake to hide taste (he knew meds were in it) but also works in fizzy juice/fruit juice/cordial/milk/water and you only need a v small amount to mix it in. It helps if drink is really, really cold too.

In this v acute moment now, I'd suggest he moves around as much as possible to put pressure on the movement, sitting on it in fear of it hurting is going to make it worse - it needs to come out. The poo nearest the anus will be the hardest as it will be drier than the poo above so reassure him that the first one may be hard but once that's gone to others will be much better.

Drink as much fluid as possible, ice lollies and so on. Lots of Vaseline around his bum just in this moment. You can also get a numbing cream via HV or GP for anus.

His foot position is really important in passing stools. He either needs a step to push his feet down on when passing on the toilet or he needs to squat on the floor and try to poo into a bag/newspaper - the lower to the ground the easier it is.

It is really, really dreadful when they are properly constipated- for both of you. He might want to squeeze your hand when he's trying and encourage him to do big breaths. The old trick of blowing bubbles is also good, it uses the same muscles as pooing but changes their concentration. It will hurt, but like I say more the first than subsequent ones. You need help today, so pursue professional advice. Keep a calm and understanding exterior for him as he feels distress.

Good luck.

Suppository will work in less than an hour in my experience 😬.

It’s sometimes difficult to keep the suppository in for long enough. They work best if kept in for at least 20 mins. Get him to lie on his side on the sofa/bed to try to keep it in and something on tv to try to distract him. It might be easier to actually poo in a warm bath while squatting if you can’t get hold of any suppositories today.

Movicol takes days to work massage his tummy clockwise always helps my DC who suffered lots eith constipation

Have you tried plain hot water - gets me moving sometimes.

You can get lactulose over the counter at a pharmacy which is a stool softener (as opposed to movicol which is a laxative and makes the bowel contract). It sounds like he has a hard poo blocking and then has watery poo leaking around the sides. I second the glycerin suppositories, again you can get them in a pharmacy.

@Straysocks OP said on her first post he’s 11,

Well, I’m still waiting on a call back!
Fortunately the Movicol has actually worked really well and quickly.
Very relieved!

He’s had two sachets so far, he can have 4 so I’ll give him 2 more later then all being well 3 tomorrow then 2 then maintenance dose of 1 for a few weeks.

poor lad i used to get bad constipation when i was that age - i grew out of it as i hit my teens. A decent walk always helped me (although don’t go too far, for obvious reasons!) and drinking warm drinks like hot squash or hot water and lemon.
A suppository might help ease the pain of that first ‘go’ and a hot water bottle on the tummy can be comforting.
Hope Gp gets back to you soon.

Make sure he is drinking a lot of water, this is vital to get the Movicol working properly. Also agree with the ERIC website best advice on there.

Thanks @FelicityPike, I missed that bit. At 11 it might be a bit easier to explain the mechanics of it so he has a bit more understanding that it will hurt at first - younger children just can't work on that basis. @Thereareliterallynonamesleft Movicol doesn't work on the bowel, it works on the poo - makes it absorb more water therefore making it wetter and looser. Lactulose is good for keeping stools soft as you make them and may be good for for longer-term management. We only used suppositories once and it wasn't a good experience for us, I know it is good for others. If you have diarrhea whilst constipated it can mean that the blockage is higher up in the tract, that the watery parts basically go around it. Let your GP that.

@frostedviolets I was so keen to respond to later posters I totally missed your update. Can you tell this subject was done to death in our house? Good news!!

He's had a bowel motion, all be it small but he's still going. If he hasn't gone for 8 days without so much as a fart then he's constipated.
At the moment, you can ring a local pharmacist and they can suggest how much laxatives to give him (because he hasn't really had enough).
You also need to be getting him to drink more clear fluids every morning, like about half a litre before lunch plus things like prunes etc.
Be careful which pain relief you give him as some make it more difficult.
Rub his tummy in a clockwise position for a few minutes lying down with knees up (him not you). Then ask him to do some walking about the house.
Exercise, fluids and good nutrition should reduce his symptoms.

Oral laxatives are good for moving things about, softening the motion through the body.
Suppositories are good for if he can feel it in his anus or to get the end of the stool to move.

My sister is 10 and wet herself due to constipation and was admitted for 2 days! I haven't gone for 10 days and was also admitted before! It's so painful

@frostedviolets - glad things have moved for now. Movicol mummies on Facebook is an excellent group for information and support, with some health professionals on there too.