Can a child's bowel problems affect mental health and behaviour?

[sleepplease1]

Hi,
We discovered my 2.5 year olds chronic diarrhoea was actually overflow - consultant missed it saying it was toddler diarrhoea! Since then have been under bladder and bowel team (B&B team) who helped to disempact him - with Laxido and sodium picosulphate. He has been on both for about a year. B&B team have basically dropped us as no regular contact or real support just say to try and reduce both drugs ourselves.
I've reduced the dose to 1 laxido a day and less than 2.5 of sodium picosulhate. I'm really paranoid he'll get constipated again and disempacting him was a nightmare for him too, BUT he is constantly complaining of tummy pain, especially around meal times.

His behaviour has become more challenging! Hes very angry, aggressive with us and it usually gets worse when we know he needs a poo.

He's very reluctant to eat normal food other than sweet snack foods - it's a challenge to get him to sit and eat any kind of meal although he does eat some healthy foods if forced. When he does go on the toilet he has lots of wind++ and still a very wet poo which isn't really formed. He is going every day though.
I'm thinking his digestive track is worn out he needs probiotics etc and wondering if anyone has had similar experience?

I'm concerned that he's just been left taking this medication at 4 years old - I've tried speaking to nhs about this but get no where. I'd happily go private but don't know where to start.

Might it be the other way around? That his gastro problems are linked to other issues for example I have two children with ND and both have had gastro symptoms. It is actually very common with ND.

I'm surprised you have been discharged so soon. My understanding is that recovery from chronic impaction takes a very long time.

When my ds was treated for chronic constipation we were told that once he no longer needed disimpactions he would still need to be on Movicol for at least as long as he had been constipated. Ds was 6 when he was diagnosed. We did a disimpaction every school holiday for the first 18m, then dropped to just the big holidays for another year or so. We reduced them according to how needed they were. You could tell by how quickly he responded. Ds's maintenance dose had naturally reduced by remaining the same as he grew larger, so further reductions were straightforward. He stopped taking Movicol in the summer holiday before he started secondary. Overall, he was on regular Movicol for nearly 6y.

It could also be the case that your ds's constipation was caused by a bowel condition such as coeliac or a food intolerance. His condition is clearly still unresolved.

We were fairly sure that my ds's constipation was caused by anxiety, but during his active treatment phase he had some episodes of pain that were so severe he collapsed at school and threw up. So the GP did some blood tests - coeliac and inflammation IIRC - to exclude any physical causes.

OP it’s worth doing some research into the gut microbiome. It’s hugely important for overall health including immune system and production of serotonin (most serotonin is produced in the gut). So yes, gut issues absolutely have an impact on mental well-being, and unfortunately many medications can disrupt the microbiome.

There’s lots of information online and books about it, and if you have the finances I’d look for a nutritionist/naturopath/dietician or similar with a specialism in gut health. Most medics aren’t really up to speed on this as their focus is treating the symptoms.

All the best

My son is suspected ND so that may be underlying his constipation. However his behaviour deteriorates so quickly when he gets badly constipated. He says he feels fine but he’s grumpy as hell.

I also think new research on the micro biome does show new links between MH and the gut. So diversity in food intake is important.

You have my sympathy- getting DS to take Movicol is a daily pain. It’s a lot to manage and very little helpful info from the kids.

If you want to go private, look for a paediatric gastroenterologist. We did that, too.

My DC is also under the care of the bladder and bowel team. We are on a similar dose as you and have been for about 2 years. I find the 3 monthly calls more than adequate. It's great to have someone check in and see how we're going and get advise about reducing the dose if necessary . We wouldn't require anything more than this. Eventually we will come off the medication but I understand that this can take years. It doesn't seem to have any impact off DC behaviour so I'd suspect that this is unrelated

When he does go on the toilet he has lots of wind++ and still a very wet poo which isn't really formed. He is going every day though.

Is he still on the picosulphate? We found that too strong. Could his maintenance dose of Laxido be too high? Does he have a lot of dairy?

I'm not a child - I'm an adult now.

I had serious bowel problems as a slightly older child and yes it impacted my behaviour, largely because it was painful.

I got a lot of wind, which caused tummy cramps. Often diarrhoea/constipation swings as well. Both are quite painful,

I responded by eating much less generally, it's a common response to tummy pain. Eating causes pain therefore don't do it and the pain will be less.

I still do that as an adult - if I'm having a flare I'll stop eating for a bit to let my bowel recover.

We have partly been through this with my daughter. Not full disimpaction, but chronic constipation and toilet issues. I suspect she is ND.

I found her behaviour absolutely linked to her constipation. But when I am in pain I'm am grumpy too so I can't blame her!

We found that it was dietary linked. Dairy was the cause and since being Dairy free she is mostly OK.

We still have some minor issues that we are working through. But she's doing OK.

I found the ERIC helpline extremely helpful. It did take a few attempts to get through but their advice was invaluable.

@Aladdinscarpet how did your children get diagnosed if you don't mind me asking? I do have concerns about him being ND

@Dilbertian he hasn't been discharged yet but he has been put on a 6 month follow up phone call. I have made calls to the team but they always say just try to reduce the doses and see what happens. That it's very trial and error. They are unconcerned about his tummy pain just say it's related to the sodium picosulphate.
Did you find a physical cause for your son's constipation? My son also gets very anxious and I have always thought it could be related. Have you found anything that has helped his anxiety? Thanks

@MySocksAreDotty it's such a pain to get him to take the Laxido. I now mix it with hot choc powder and add some milk after to make it into a hot chocolate!
If you don't mind me asking what behaviours have made you suspect your son is ND? I do have concerns that some of my son's behaviours point in that direction. Nothing has been flagged up at nursery or preschool but his behaviours at home seem quite different.

@CheesecakeBase thanks so much for your message. I find research into the gut microbiome really interesting, especially the link with mental health. Currently reading GUT by Giulia Enders and have just started listening to Unprocessed by Kimberley Wilson on Spotify.

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@Grasshopper7 that's great you have had a good experience with the team. I think for my concerns are around his tummy pain and reluctance to eat meals especially when we go out which he says is due to the pain. I'm thinking behaviourally that his bowels problems can't be the only cause but I do think it makes him very anxious and angry

@Dilbertian thanks for your message. Yes he's still on the sod pico. He does have a lot of dairy, it's hard with his limited diet to cut it out or even down but I will look at an elimination diet once he has settled into school

@Octavia64 this makes total sense thanks. Yes he does seem to avoid eating and he is in lots of pain and often if we encourage him to go to the toilet to try and open his bowels he will be able to.

@supercalifragilistic123 so interesting that it was dairy related. I am dairy intolerant myself but did have it during my pregnancy with him. I will definitely look at doing an elimination diet once he has settled into starting school in a few months time.
I also didn't realise Eric had a hotline so thanks I'll give them a call for advice