Does anyone have experience with impacted poos and "overflow"?

[Caz10]

And apologies to those who are eating their tea!!

Long story short, DD 3, recently potty trained, withholding poos. Gone from once a day pooing when in nappies to 2-3 times a week max sometimes less.

Now we barely ever have a "proper" poo, just constant, almost hourly small poos/skitters in pants - it is driving me mad.

After asking advice on here and doing some mad googling, the common consensus was that she probably is constipated, the skitters are "overflow" and she needs medication to help clear it.

So off we go to GPs, who only basically agreed with me and offered no new advice, and back on the lactulose (I tried it before but only for a week, I didn't realise how long you had to give it).

Anyway, sorry that wasn't short, my questions are:

• if it was "overflow" would she feel it coming? When a skitter is about to arrive I can see her doing her poo face, turning her back, she tells me to go away etc - all classic I'm holding in a poo signs, which means she knows a poo is coming - that makes me wonder if it IS overflow?
• if your DCs have had this problem, do you have any magic wand answers?!! Bribery just not working.

She has pooed successfully a handful of times both on the loo and on the potty, and if I catch her in time is not averse to being sat on it, so don't think she is terrified or anything?

Just can't wash pooey pants for much longer, sob!!

Thanks sneezecakesmum, I wouldnt go down the suppositories route as like you say I think that will cause more issues, Im just frustrated with the doctor. is it ok to give laculose without the docs permission? i just want to help my son x

will look up info for you.... cant really advise but can point you to NICE guidelines on constipation if it is constipation and not with holding. witholding is another game altogether.
www.medicines.org.uk/EMC/medicine/2504/SPC/Duphalac/
Def for constipation so if you thing LO is constipated this should help clear him out, but it may be witholding and issues with using school toilets. My DD wouldnt contemplate a school loo.
As madwoman says if its witholding its to do with behaviour and training.
You can give lactulose without medical permission but I would have a discussion with the pharmacist first

ok, its not with holding as he is generally on his way to the toilets. I thought at first it was because he was too engrossed in what he was doing and leaving it til the last minute but he will go on the toilet if he makes it in time. he has done it at home a couple of times too.
x

if he's on his way to the toilets and having an accident then i wouldn't be giving lactulose - that's liable to make it worse tbh... much better to get a routine in place.

There are such nurses as continence nurses who are experts in this field, not sure whether you go to one via the unhelpful GP.! There could be all sorts of issues such as food intolerances, genuine constipation? Maybe if you use the holidays to observe and get a real idea of whats going on.

Have shown this to Dh he now thinks stop the lactulose, which should stop the skitters, stop mentioning it really and just go with the praise when (if??) she does go.

!

A big normal poo in pants would certainly be easier to deal with than 6 skitters a day...

the problem is if he has this 'overflow soiling' where there is faecal impaction so watery poo shoots past it then surely he needs to get the impacted bit out first? the holidays would be ideal to do this. i dont know if it is this, it seems very like it but unless GP diagnoses Im not sure what to do. Appreciate all the advice here though xx

The problem is Caz if she has an impaction then she needs something to shift it.

impaction can take six months of lactulose (plus good diet) and toileting routine as above to dissipate.

'the holidays' probably isn't going to cut it...

am currently looking into diet etc. ds has traditionally healthy diet (and was tested for coeliac etc as part of his incontinence investigations) but am looking deeper into other potential issues.

ds was originally dx with impaction (he has had a fair amount of tests from ultrasound to x-rays, to bloods etc) but did not respond to the six months of lactulose/ routine change. the next doc said the 'impaction' that showed on the x-ray may just have been the next stool on it's way through anyway, as his tummy was very easy easy to palpate and he may never have had an impaction in the first place...

honestly? i'd try a new toileting routine and check diet, and if you suspect impaction, then try lactulose for a month or so and see if there is any improvement.

one doc told me that boarding school would be the cure. he also told me to get ds to wash his own pants, as that would stop him.

still soiling.

Garrr it is so very difficult isn't it? Does anyone know how long it would take a blockage/impaction to build up? This is a relatively recent problem for us which makes me wonder. I might try the other GP at our practice at not put any words in her mouth this time! They said they wouldnt examine Dd so I don't know how on earth we are meant to know if it is impacted or not?

3-7 days for real constipation going onto impaction. Worse if any dehydration had taken place. Look for hard tummy, especially in the left hand corner. tender in the left corner. reduction in appetite (if youre all bunged up you have less inclination to shove stuff down the top end - think blocked drains!) nausea sometimes. Pain or discomfort when passing stool (its hard and dry and can scratch the lining of the rectum). Hard, dry, small dark stool

I think caz it sounds behavioural if you have none of this.
One form of examination is a finger in the bottom to feel the impaction - NO WAY is a gp going to do that! Feeling the tummy is a reasonable request though, but maybe they didnt want to scare DD and increase her fixation.
Routine and praise/reward usually the best route.

Oh wow that quick?? as thinking weeks! Goodness.

Anyway DD still eating like a horse, and what is coming out is squidgy (although she does have a week of lactulose behind her), so I am really erring towards it being behavioural.

So off to the shops this weekend to buy poo presents...!

Thank you for all your help!

Good luck Caz.! Good healthy diet, plenty of fluids, praise, star charts, bribes!! Fingers x

PS. DD is ahead of the field regarding constipation, as lots of the other mums can testify, constipation and/or witholding in young children is a nightmare to deal with. Some little ones suffer constipation despite good diets, fluids and lower grade (lactulose) stool softeners!

Poo. In. Toilet.

!!

Not getting too excited as we have been here before, but still...! And we also had one in the pants earlier..

DD still coming down off the sugar high from her huge reward!!

My dd was exactly like this - peanut sized poos all day long, never a big one. This was when she was still in nappies, about 3 years old. I delayed training her 'cos I couldn't face continually dirty pants. I came to the conclusion it was habit / fad / behavioural rather than impaction, and in the end just sorted itself out as she got into a routine of going 'properly'.

Glad to hear it sorted itself out! I think I could cope with
-little ones in loo all day

• big one in pants every day

but the 6 or so little ones in pants...waaaaaaaaaargh!!

Just as an idea for poo presents (as it can get expensive as dd would sometimes go about 3 times a day when she was clearing impaction and starting to be proud she was doing it on the toilet). We used to buy party bag toys like bubbles, finger monsters, tiny pens and paper etc and put them in a bag and she used to pull one out at a time. She thought this was brilliant and we got her a princess bag to put all her poo party presents in

Oh great, thank you! Did manage to chat a little with DD about it and she started asking for things like Baby Annabel and Tinkerbell DVDs!!

Going to have to bring her down gently, she would love the bubbles etc though!