How long before I should ring OOH (if at all)?

[doughnutty]

DS is constipated. He is screamimg in pain because he's holding it in. Started in earnest yesterday afternoon so by the time I realised it was too late to call gp/hv. But only then realised I couldn't remember the last poo. Might have been 3/4 days. He normally goes every day or twice in a day if he has one poo free day. He's 2.3 and has good vocab and understanding but he obviously doesn't understand the concept of "no pain - no gain"

He's passing liquid which soaks straight into his nappy, but what's left is like sand! Really gritty. DH and I have been trying to pull it out when we can but it's really difficult and we're scared of hurting him more.

He had a bout last week but he was ok in himself. This time he's lethargic, shivery and hot while he's straining/holding. Hasn't eaten much today and can't force him to drink much. I have got some orange juice in and a wee bottle of flavoured water (won't drink it straight).

If not doctor worthy, what else can I do. I'm almost as distraught as he is.

Now we have a spectacularly sore bum presumably from nursery not putting cream on at every change or a different brand of wipes. Not their fault. I forgot to mention it.

So, he's back to resisting changes (and bath) because it's so sore.

Supposed to be in again on Friday, just for the morning, but I'm torn. He was fine yesterday til naptime when he wouldn't settle. If he goes tomorrow he has his nap when he comes home. Do I send him??

I wouldn't send him tbh use cotton wool and warm water to clean him then let him have some nappy free time (either lie him down and put a clean nappy loosely around while you read him a couple of books then cover in cream - bepathen is great or if you can let him play without a nappy on a changing mat with a towel under.

If I didn't have a baby crawling round I would leave him nappyless, but she's into everything. Can't chance her catching something.

He will watch telly for periods so might try to let him go then and put her in the walker out the way.

He is literally pooing every 10 mins tho so his bum isn't getting a chance. I am amazed we had this long before it happened. I could kick myself - and his keyworker tbh. Who doesn't put cream on a child who needs frequent changing??

Gutted!!

I would put cream on if it was even a bit red tbh Just leave him to air dry every nappy change and put cream on and he'll be fine soon.

We had been putting cream on religiously, even though the skin wasn't red, from the word go even if just for some lubrication.

It was the morning at nursery. I never thought to ask what wipes they use or request cream after changes because it never occured to me. They changed him six times and only applied cream after the last one when he was already red and sore.

I just feel like we've taken a step back. We'd finally got him sitting at the table for meals again, instead of kneeling at his drawing table where he could run off and refuse to eat/drink. He's always been so good at the table, mainly because he loves his food, but now it doesn't hold his attention.

Going to try to talk to my boss today about using some holidays on the afternoon I have him in nursery til he can make it through the day. And one of the managers at nursery has an older child who uses movicol long term, so I'm going to see if she can give me some ideas too.

We have 4 more days of 2 sachets. At the moment it's mostly liquid with the odd bit but nothing you would call solid. But my concern is now the clenching. You would've thought he'd be less aware of it by now, but he's still stopping in his tracks with it

Just changed him and used cotton wool. Left him to dry off and before he's dry he's poo'd again. Wipe, dry, poo, wipe, dry, poo!!

No wonder he's sore!

I've had to leave the room (dh is here) because I'm crying as much as he is. He's screaming so much he's sweating and his heart is racing. He can't lie still and he's thrashing with every wipe. I feel like we're torturing him. I just want him to be well again. We can't even go to the park as he'd poo before we got out the door. We've no garden, so, apart from nursery he's not been out for days on end. Car journeys are hellish, even short ones, as he doesn't want to sit on his bottom. I am at the end of my tether now

When is this going to stop???????

Can you get Cavilon cream from chemist, it's a barrier cream, will protect the area.

Did he get a scan to get checked for a blockage further up?

No scans, just prodded tummy, though tbf he wriggled so much and screamed they couldn't have done much more. Though, for paediatricians, they seemed incapable of putting a toddler at ease. I don't think they spoke to him just whipped the stethoscope out.

Will try the chemist tomorrow, thanks fanny. Been using metanium, which is better than the sudocreme, but it must be stinging him.

Just had a thought. I have a tub of epaderm. I could put some in his bathwater. He's not happy about going in atm but that might help, no?

Cavilon is good stuff. Would try epaderm as a barrier cream as well as in the bath.
Poor mite

I think you need to bring him back again to hospital, they need to find the reason for this.
The amount of loose stools still sounds like overflow.
I really feel for you it's just awful for your poor wee chap.
Bring him to hospital and demand they do a scan and investigate this further.

I'd just go and sit in a&e with him, refuse to move till he's been scanned and they can help make him more comfortable. Poor little mite.

Agree. Maybe not A&E tonight, but Def needs seeing v soon.

God! Do you all really think so?? At this rate he'll be traumatised by doctors. We'd be hours waiting too. Might ring nhs direct and see what they say. Will be OOH again though, it always is with a child. Our OOH is in the hospital. Last time saw nurse practitioner only. Could insist on seeing a doctor I suppose.

Aside from nappy changes, which, before Wed when he first got sore, were getting much easier, he is reasonably well. He's whingy and demanding and stroppy. But, he's 2! He's also chirpy and chatty.

I am so not sure about what he's passing now. It's like (tmi) partly melted chocolate. So more like normal poo, just melted down a little. But, I keep wondering why he's clenching. I don't think it's pain. He just doesn't want to go. Might be he had a sore poo way back when this all started, or, it might be that he's got so frantic about nappy changes he knows pooing will cause that.

He won't be distracted while mid-clench, certainly won't sit down to try to let nature take it's course.

A&E though? Really?

Not a&e I wouldn't say but you need a referral to a specialist paediatrician ASAP.

What a time you have been having with this.

Because it's been painful, he is holding on. This creates a vicious circle of pain and buildup. He may still be constipated higher up and this is overflow.
There should be a constipation and soiling service in your area, and he needs assessing by them.
I think he may need assessing by a paediatrician, if you do need to go back to A/E, then ask to see a paed.
ERIC website and helpline is good.

Info on that website is interesting though seems to be more relevant to older/potty trained kids.

This mornings been a little better. He actually left the room a second ago and, I heard him making noise like he used to when he was pooing. I asked what he was doing and he said "I'm trying to do a poo" Strangely, this has made me happier than anything else in the last few weeks. When he came back in he'd done something. It even smells better, more usual, not that it's been bad, just wrong iykwim.

Dh has just taken him to change his nappy. We'll see what the results are. Fingers x'd

Fantastic news. The fact that he is trying is great.
Would he sit on the toilet or potty to try? He would be able to bear down better and push more out (if on the loo, would need a footstool or something to put his feet on to help)

Not potty training yet. Don't want to scare him if it's still painful then have that association.

It was a whopper! Probably no. 2/3 on that scale. But, up til now they've been 1/2's. There was something that had been solid in there but tbh there was so much (he'd leaked out of a size 6 baby dry) it was hard to tell.

We're at soft play as a treat for him and it's great watching him run and jump and play.

I know it's not over but he seems so much happier. He actually asked to come out. He's been screaming about leaving the house for weeks.

Not potty training yet. Don't want to scare him if it's still painful then have that association.

It was a whopper! Probably no. 2/3 on that scale. But, up til now they've been 1/2's. There was something that had been solid in there but tbh there was so much (he'd leaked out of a size 6 baby dry) it was hard to tell.

We're at soft play as a treat for him and it's great watching him run and jump and play.

I know it's not over but he seems so much happier. He actually asked to come out. He's been screaming about leaving the house for weeks.

Good news.

By sitting on the loo, I don't mean toilet training, I just mean for him to poo in a sitting position, which can help him get the poo out, sorry to be confusing. I agree with not doing anything that could scare him tho'.

It's great to hear he can have a fun morning for a change.

Sorry for the double post. Didn't even know if it'd worked once. Stupid soft play is in a valley with no wifi!

Had another spectacular poo when we changed him before leaving. Dh thinks there can't be much left in there and the constant cramping seems to have abated.

He ate a huge baked potato with tuna for lunch. Must have made room.

Happy, happy ,happy in the doughnutty house. At least for now.

My dd2 had constipation issues around this age for a while, started with the gritty, sandy poo before moving to mucousy faeces (tmi, sorry). We were referred to hospital, as outpatient for over a year. The main concern was impacted bowel,where it stretches and if left untreated won't return to the original shape. The gritty, mucousy poo is only what can escape past the impacted faeces in the bowel. I'm surprised your poor ds hasn't had any scans, we had loads!

Soft play and swimming are great for getting things moving, as it gets them bending, stretching etc. Dd2 always had great poos after soft play and more embarrassingly, during changing after swimming. If you can, get him out and moving as often as possible. Hoping he feels better really soon x.

I'm pretty sure he made it through the night without soiling. He had only a smear in his nappy first thing.

Went off to hide earlier and returned having poo'd. Dh changed him. Said it was still like raw cake mix (dh's words) but, there was a whole chick pea in there. We had a stew with chick peas on Thu for tea.

Do you think we're safe to assume that means there's no more blockage? Got today and Mon to give 2 movicols before cutting back to one. Dh is inclined to cut back already given the evidence. I'm not so sure. I'll definitely give him the second one today.

Going out with pil for mothers day lunch today. We were thinking just 2 days ago we wouldn't make it. We've even packed to stay with them tonight. They have a garden so ds can run around outside without worrying about being too far from changing facilities.

I'll let you know how it goes. My only concern is getting him to sit still in the restaurant. He's always been really good before but he's got used to getting down from his chair with the cramps. Need to take something to distract him.

Well, he went a full 2 hours before bath with no soiling. Hurrah!

However, now the wee one is ill. Thrown up twice. Once, just as we sat down in the restaurant to eat today. And, tonight while trying to put her down at pil's house. Drenched herself both times. Poor wee soul.

It's going to be a long last week of ML, and not in a good way