16 mo severe pain when pooing, please help

[NeedToSleepZZZ]

Hello all,

Really looking for some help here as I don't know what to do for the best.

DS is 16 months and has had problems with pooing since he was weaned at 6 months. He doesn't go very often (about 3 times a week at the moment) and when he does, he strains, sweats, cries, screams and shakes with pain. He locks his knees and clamps his legs together to try and stop it (I think) so I sit him facing me on my lap with his legs apart and his bottom slightly lower than the rest of him. This can last for half an hour at a time and sometimes produce nothing, just a fart.

He has been seen a couple of times by a paed at the local hospital and he has told us it's probably constipation and to keep giving him movicol (he's been on it for about 4 months now, lactulose before that). He has one sachet a day and his poo isn't hard at all, sometimes it's more like diarrhoea tbh. He drinks lots of water (about 5 cups a day) and has a varied diet with lots of veg (not so much fruit as he doesn't have a sweet tooth but will have dried fruit).

He had a couple of blood tests 2 weeks ago and I'm chasing up the results atm but I don't see how these will show anything.

I don't understand why the paed thinks it's probably constipation as he doesn't have hard stools and surely if it were that the movicol would have sorted things by now?

Not sure if it's relevant but he also has a large(ish) cyst on his penis that he is due to see the surgeons for next month. Probably nothing to do with it but don't want to drip feed!

Thank you for reading, I would really appreciate any advice on what this could be and how to get the doctor to take it seriously.

Oh, just to add that the doctor hasn't been able to palpate his stomach properly as DS screams when he touches it, I think it's because he's scared of the doctor as I can feel it at home.

bump?

Could it be an allergy? Sometimes wheat allergy can present like IBS, with problems like bloating, gas, a swollen stomach, fluctuations between constipation and diarrhoea. You could have a go at eliminating wheat and gluten and see if that helps?

Also, babies and toddlers don't handle fibre too well so things like too much whole grain foods, veg (obviously you want him to eat a little for vitamins), fruit... he will find hard to digest so it will all slow down. A good way to cut down fibre is offer refined carbs as they're easier to digest and peel the skins off fruit and veg. Make sure the veg is well cooked, even offer stewed fruit instead of raw.

A good aid to digestion are probiotics. Live yoghurts instead of children's ones, he won't know the difference. Activia or yakult which you just mix into his regular milk. Even probiotic capsules, crack them open and sprinkle in his milk. The good bacteria in probiotics start digesting your food for you so your body doesn't have to work as hard. Especially if he's ever had antibiotics as they will seriously mess up his digestion as with him still so young, his gut is still maturing.

Try cutting down wheat and dairy. I'm a nanny and the little boy I look after had the same problem at that age... We started him on soy milk and cut down wheat completely. I also used to add ground linseed on his porridge and some with the afternoon fruit, that seemed to help him a lot. After a while, his bowel movements regulated and now he's absolutely fine.
GL x

I remember listening to a radio program where a medical doctor was explaining about constipation

she said not to be afraid to give light medication to help to pass stool - too much fiber will clog anyone's intestines up

I remember an advice form a chemist was to give water with brown sugar to babies

maybe ask pharmacist what to give to 16 mo toddler and follow up with light diet and not too much wheat fiber - I think bananas are good

thank you for your advice and tips; I think I'll try the probiotic yoghurt with ground linseed and see how that goes.

I tried for a couple of weeks just giving him pureed, cooked veg instead and no bread, porridge, anything that could clog him up but it really didn't make any difference unfortunately.

As we're veggie, I am worried about cutting out too many things as I want him to get all necessary vitamins and nutrients. He's already been straining this morning, yesterday he had about 5 small poos and they hurt him so much I had to change his clothes from the sweating and yet the poos were soft, just small.

We are carrying on with the movicol but it's so frustrating not knowing what's causing this.

Could he have an anal fissure? Hurts like bollocks even with soft poos and would certainly explain why he doesn't want to go.

Constipation can have symptoms such as diarrhoea or normal stools, as there can be a hard lump of faeces higher up that the other faeces squeezes past. Sometimes X-ray is the only way to diagnose this. But push for more action from a doctor as long-term constipation can lead to double incontinence.

Banana can actually contribute to constipation so wouldn't recommend them.

And the researched advice is lots of fibre and stay hydrated, not less fibre.

They don't always have sufficient enzymes to digest grain-based foods till they're older (and it's matter of debate whether humans should be eating as many grains as we do anyway) so it's often this that causes the problem rather than the fibre itself. Rice should be the least problematic one, but you could use quinoa (not actually a grain) instead.

As long as he's still getting enough breastmilk you don't need to worry about nutrients as any gaps should be filled by that (and a higher proportion of milk would help anyway).

u have so many questions you need to go back to yr pead.

some babies have a milk intol problem that irritates the lining of the anus.
it causes extreme pain when they pass normal looking stools.

ask pead or gp if that might be the problem. ask if you can have a allergy formula for with partially or fully changed protien and exclude all udder milk (apart from human if breast feeding!) for at least 6 weeks before a def improvement can be shown.

if doc agrees, you may want to consider seeing a dietition and ask to be reffered.

good luck.

Sossiges, he does have a fissure which the paed told us would heal in about a week but that was months ago. We've tried putting germolene on it when he needs to poo so that it numbs it but it still hurts him.

I called the secretary today about his blood test results and was told that the senior paed had requested his notes and would be calling us tomorrow, I don't know if this is because the other doctor is on holiday or something but I'm a bit scared now. He managed to do a larger soft stool this evening after straining most of the day and me having to pull a couple of smaller ones out. We've kept some of it as a sample in case they need it, it looks quite dark in some places and I'm so worried it might be blood in there.

Oh, he isn't bfing anymore as I had to stop when he was 6 months due to medication I had to take so he's been on aptamil but I was mix feeding before that for quite a while.

I had fissures for 6 months, my cure was magnesium (different things seem to work for different people), definitely worth a try. Having an AF was the worst, most painful experience I've ever been through and I tried everything. Magnesium did the trick, within 24 hours I could hardly feel a thing and the AF's healed up by themselves. I think that magnesium deficiency causes them. If you would like my advice (FWIW) get some Magnesium supplement capsules from Boots (Boots own brand) make a little hole in one, he's 16 months so I would give him 1/3 to 1/2 of the contents of one capsule. Easiest to squeeze it onto a spoon and put some jam or something else he likes on top, or try it between two chocolate buttons like a sandwich. I really don't think it will harm him, I give it to my daughter when she gets constipated (moves things along like you wouldn't believe). If he has less pain pooing the next day, it's worked. Germolene might not have much effect, there are masses of nerves and AFAIK the pain is caused by a sphincter muscle going into spasm, magnesium relieves the spasm and therefore the pain. If the AF is his main problem, I am confident the magnesium will cure it. All the best