Anyone have experience of SENNA in poo witholders?

[HiggsBoson]

Hello :)

Could do with others' perspective on this.

DD (2.7) has been potty training for 4 months and has been dry from day 1, but will avoid pooing at all costs.

We've been referred to a 'poo doctor' who prescribed increasing doses of senna to disable DD's poo witholding ability.

It's not really working :( We are up to 25ml per day and she can still hold on to the feckers!

Every day is blighted by DD screaming, dancing and holding on, waiting around for her to poo and generally being on edge and ultimately dealing with VERY messy & runny senna - induced poos. Grim.

The poo doc keeps saying increase, but I'm not sure this is working for us. We're also getting the patronising 'blow bubbles on the toilet' advice, but we are WAY beyond that.

I have tried EVERYTHING :(

Anyone else have experience of this?

I think she IS ready though Brandnew she's been dry from day one and, like I said, she KNOWS when she needs to do a poo, oh boy does she know!

My ds used to withold. We had all sorts of trouble with poo that started off when we began potty training. His witholding led to constipation which led to wetting etc.

Anyway. We were given lactulose at first and similarly told to the does and increase it again until the poor boy was desperately trying to withold liquid poo. Frankly it was no use to man or beast. Eventually we got another Dr and were given fybogel because he thought that would bulk the poo up and therefore increase the sensation of needing to go so make it more difficult to withold but without making it runny. It worked very well although he would still go a few days between poos and we would get some soiling in between so we then added a very small amount of senna which kept things moving a bit more. With that combination we managed to get him going daily.

We also did the sitting him on the toilet thing. I think that is important, although it is a little artificial most people have a time of day they tend to poo so you are essentially training your child's bowls to have a time. Ds goes right after dinner and at first sat for 10 to 15 mins and we would read him stories to keep him occupied. Now he goes off himself after dinner and does a poo right away. We have been able to stop all supplements now and thogh we still have the occasional blip he is mostly ok (5 and a half now).

I have no idea whether you can stop it dead, or have to reduce over time - if it is the same as some of the other laxative stuff, it is better to reduce gradually, as stopping abruptly can cause constipation and encores is (which you really don't want complicating the issue)...

I would pop and ask a local pharmacist.

Have you got another appointment booked with doc? Tbh, I just wouldn't bother making another one and just leave it for a few months. If you have one booked, I would be tempted to cancel. The doc probably won't even notice.

Then you can call back at some point in the future and resurrect the conversation if you need to. All you need to say is that on reflection you felt she wasn't ready to potty train, and had decided to give it a few more months for her to mature some more before you tried again.

Tis easy.

I don't think the doc is waiting with baited breath....

Point taken :)

Oh and dd also soils a fair bit and ends up pooing everywhere, drives me mad but with her it is all attention seeking. She ended up potty training through a lot of stress with ds so picked up on poo being a big issue . I just hope everyone is fully continent by the time ds2 gets big enough to pick up on it!

encopresis. Not encores is. Fecking iPad.

We're booked for another poo appt on 19th October, but I'm not confident about this woman at all. It's 100% behavioural imo.

We are doing 'potty time' after meals, but it has never coincided with a poo yet. Even if she is desperate to go at that time.

I'll look at introducing pull-ups, adopt a 'fuck what everyone else thinks' attitude and see how we fare with that :)

19th September ffs - next week!

What on earth is a poo doctor? My normal GP dealt with my DS's constipation (which was witholding more than proper constipation). Lactulose didn't really work, but what did help him to go was glycerin suppositories. We were recommended them to make him go every 3 days, so I'm surprised that you were told that not going every day was a problem - I think not going every day can be completely normal.

What helped with us when potty training, as he had been 'cured' for a while in nappies but started witholding again was a suppository to clear out at the start, then later every couple of days to 3 days if he hadn't gone talking about how sore and big his tummy must be with all that poo in it then sit him on the toilet and tell him he needed to poo. We would hold his hands and encourage him (and not let him get off) until he went. Then there would be a big fuss, chocolate buttons, dancing around the room etc, and exclamations of how much better his tummy must feel. He usually goes quite willingly every day or two now (after a couple of months or so).

Oh, we've had a poo doctor. Enuresis clinic.

That said, wtaf you are doing with a poo doctor and no constipation/ encopresis at 2.7 is beyond me. It was a minimum of 5yo for us. Prior to that, without any co-morbids, it's (usually) just a maturity thing.

Have you seen the eric website? I don't even know where to begin with the doctor's rationale, tbh. It's so far beyond what I would be familiar with for a 2yo, and much much more suited to an older child. But maybe advice has changed and they are intervening much earlier. It seems counter productive though.

Eric have a helpine, too, I think. Their forum used to be a bit hit and miss, but you might find something helpful. They would definitely be up on best practice in this situation though, so I do think it would be worth a look.

Thanks again for all this help :)

Oh dear - it seems as though the gun has been well and truly jumped in terms of our referral to the clinic!

She was definitely witholding and getting into a right state, but never became constipated - we gave her a spoon of syrup of figs, plus lots of water/pears/broad beans etc to encourage fluids & fibre. She is a good eater - small mercies and all that.

I was referred by my HV - I think it was as a preventative measure as they were worried it might lead to the dreaded encopresis.

'poo doc' said every 2-3 days isn't normal and must be every day. Blimey - well I'm really lad I posted here, it's been a great help!

Check out the eric website...

My son(one of twins) had real poo withholding issues. Did not start training until after 2.5 years. Quick to learn for wee but was withholding for up to five days. GP did not offer any medication! Felt he was scared of pooing...he would run around throwing himself at the sofa when he needed to go but did not want to. I tried stickers, sweets etc but the only thing that worked was him wanting to earn toy cars for a poo. Once the first one done it got a lot easier....he earned quite a few cars from our poo treat box! He is now five and pooing ok but have to say he still does not like it much...seems to do massive ones too... Probably the reason for his problems. Your 'friends' who say you should not be in nappies are unkind. Loads of children are.. Just look a bit further. Those who are trained early have so many accidents too I find. Also MIL from a different era where people did potty training very young because washing cloth nappies was such hard work.
Hope you find a way forward that works for you both. X

Tried to post before but lost it .

dd had similar problems when pt. Pooing on the potty scared her and then she started withholding. I sorted it out in the end by putting a nappy on her whenever I saw her start to bear down - after a few weeks she was asking for a nappy whenever she needed to poo (every 3-4 days). Once I thought she had completely lost her fear of pooing (a couple of months later) I bribed her onto the potty by putting a large reward (a book) on a high shelf in the bathroom and telling her she could have it if she pooed on her potty.

I made some half-hearted attempts to help her through diet, but they didn't make much difference. We read "Poo Goes to Pooland", "Everybody Poos" and "It Hurts When I Poop". Not sure if any of those helped, either, but dd now delights in explaining to everyone the journey food takes through the human body!

My DD didn't potty train until nearly 3. She had similar issues and would want a nappy on for a poo (I let her do this). We used lactulose for the times when she clamped up and that seemed to help with no ill effects. Then with gentle encouragement (and lots of praise when she did a poo on the potty) she got there without too much trouble. They get there when they are ready. Stop worrying, stop comparing...

The posts suggesting you ignore this and relax are very dangerous. The longer the poo is withheld, it stretches the bowel walls which take years to contract again. We were on 20ml for my DS for 4 years and I got more and more worried. I got referred to Great Ormond St. The biggest thing the Consultant did was reassure me that years on Senna (which is a gentle drug) were absolutely fine. There are Norwegian studies that show 20% of children with withholding are still taking Senna at the age of 16. The dose must be high enough so that the bowels are completely cleared out first thing in the morning. Then there will be no accidents later in the day and the bowel walls can mend. You must accept its a long term solution and find the dose that works for you. My son started school having 6 accidents a day and now he is in year 3 he doesn't have any. I have no plans to reduce the senna for a couple of years and we'll do it slowly. Now he is older, we are in a balanced, relaxed place where he can manage his condition.

Gosh OP I feel for you. My three year old is nowhere near potty trained and only poos twice a week. We are on movicol for that.

Your mummy friends sound dreadful! Where I live no one gives a hoot about your kid being PT and three is normal. Sack them off and hang out here with us

When DD started to withold poo when potty training we went back to pull ups for poo. Firstly just didn't talk about it at all, then after a while slowly asked her to sit on the potty or Loo to poo with the pull up on. Such a slow transition to remove the stress

I'm surprised you've been given senna when Movicol is usually the first line treatment. But you say despite the withholding she never, ever got constipated?

The problem with Senna in my opinion is that it's a stimulant laxative and causes cramps. Movicol is merely a stool softener and has no stimulant effect on the gut. Could she be in pain and that's exacerbating the negative feelings around pooing and therefore the withholding? Because it's totally behavioural, obviously.

Zombie thread from 2012

Shit, didn't even notice