Any help with chronic constipation in a 5 year old PLEASE!!!!!

[DaysieGoneBananas]

Hi I took my son to see the GP about a year ago as he wasn't pooing until he went to bed. every night (and I mean EVERY night) he was pooing himself. He wouldn't go during the day at all. His pants always were dirty as the GP explained there was fluid leaking round what was sitting in him as he wouldn't get rid of it. He constantly had tummy ache. GP (lovely man) prescribed senna for him and explained that it may take up to 18 months to sort him out properly.
DS started going everyday at about the same time and things started getting better. Then suddenly he has started holding it in again and won't go. Things were awful last week he was utter agony with tummy ache and I held his hands while he tried to pass it and he was sobbing his heart out. Took him back to GPs (lovely doc now left saw different one, lady who seems to think you are wasting her time) she gave him lactulose.
I was just wondering if anyone else had had this and how long your children were on the meds for and how long it took to get better. Also did youhave any set backs. I'd say it was school but he's been there now for over two months so I don't think it could be that.
TIA

you could try prune juice or fig extracts.

"suddenly started holding in" - what happened just before?

try and see another, more sympathetic gp

also a consulting a nutritionist might be a good idea - look at his diet, fluid intake, other habits etc.

Has your son ever been checked for piles? My DS ( 10 years)has had a pile for as long as I can remember. First noticed when I was changing his nappy so he was very young.

He holds just after he has had a painful poo. We also give him lactulose which isnt very effective. We were prescribed "movical" last month but he had an alleregic reaction to that so back to the lactulose.

There was nothing that happened as far as I could tell that made him start holding it in again. He doesn't seem to have anything like piles although perhaps they are internal will mention to doc.
Tried prune and fig and I have two girls who eat the same as he does and they are absolutely fine. He drinks ALOT (in fact I was worrying about him maybe being diabetic he drinks that much!)
I had a fissure when I was little and I wondered if this might be what was wrong but doc says not...got an apt Wednesday to see if they can shed anymore light on the matter.

daysie "eating the same as DDs" - well they don't have a problem, but he does, so I think it would be worth looking into his diet, could he have irritable bowel syndrome or food intolerance or allergies

(sorry, I'm sure he's fed well, that's not what I mean, but something is causing a problem, so it might be a good idea to try a food diary, so you can analyze his diet)

I don't know how old he is or how he can express himself to you about it, but I just wonder what's going on in his little world... what does he say about all this?

when I was little I sometimes wondered that if I fell in, would the whirlpool of flush take me down?
(didn't occur to me, that if I fell in I couldn't possibly also flush as it would be out of reach...)

maybe he hates the loo/bathroom, or has a fear of some kind or feels insecure with the gap under his bottom

a friend's daughter would do a poo and be sick coz the sight and smell of her own poo made her gag and vomit. she found it revolting and hated doing it!

is trying a potty an option? or suppositories?

(I feel like saying give him a fag and a coffee, best cure for hubby., sorry...)

no other ideas, I'll be thinking about it though...

I asked the doctor about allergies..my mum is coeliac so I was concerned it could be something like that. Doctor said nope ..food allergies in children would present themselves as loose and unable to control 'passing a movement' (as the dr put it. Love the way they put things) so that was dismissed. I am going to see a different GP to see what he says as he has a specialty in peadiatrics so hopefully that will help.
As for diet...its one of the first things I looked at. I've given him extra bran and stuff in his cereal on a morning, loads of fruit and veg, baked beans even fig rolls (he won't eat figs on their own)
I'm at my wits end honestly I am tempted to get him to drink some coffee and eat a bacon sarnie cos if I give that to his Dad he's lost to the bathroom all day!!!
I think it hurts him but he can't tell me how or where.

Daysie - it is possible to have constipation and be coeliac, with a close family history I would ask to be tested, it's only a blood test initially.

I asked for him to be tested. GP refused. Said there were no signs that he was. Can I insist that they test him?

just thought - bran and whole whet cab make him constipated actually!, try white bread for a while?

agree with blueberry , get him testes, and yes, insist and don't feel guilty or whatever!
sod what gp thinks, he's not suffering!

i meant whole wheat can...

Daisy - if you are increasing his fibre then you need to increase his liquid intake too. At this stage I wouldn't really worried about what he drinks as long as there is lots of it and yes do push and insist on being tested.

Been to docs.
Still won't test him for Coeliac as it would mean he would be underweight and he wouldn't be constipated at all, would be the opposite.
He has been put onto movicol now instead of the senna and basically told to use reward charts for him. again.

oh FFS ! poor you &him!

this was on the NHS website, so call your gp and read it to him!

Symptoms of coeliac disease can range from mild to severe.
Recognise the symptoms:

indigestion
mild abdominal (stomach) pain
bloating
occasional changes in bowel habit, such as episodes of mild diarrhoea or constipation
anaemia (tiredness, breathlessness and an irregular heartbeat, caused by a lack of iron in the blood)
loss of appetite
weight loss
tingling and numbness in your hands and feet (peripheral neuropathy)
vomiting (usually only affects children)
some loss of hair (alopecia, usually only affects adults)

other thoughts:

can you get an allergy/food intolerance test done? could he have IBS?

or a child psycholigist? I do think he might be frightened to do a poo for some reason - I do not think he's nuts!(smile)

I'm clutching at straws, and I have who's a nutritionist I'll ash if she can think of something...

thanks for that..got me panicking now cos most of those symptoms I have MYSELF! eek!!
I don't know about IBS..although that goes hand in hand with Coeliac (Mum has that too) I think i might look into getting the tests done privately or something...anyone know of anything?

Would he sit on a potty, as it is a better position to use? Movicol is supposed to be great, so try that. Also a little vaseline wiped on before a poo (and called 'special lotion' or something) helped my ds. Some people have had success with blowing bubbles - if you pretend to do it you can feel a sort of 'relaxing' in your bottom. (Can you guess I was that mother!)

I#m doing the bubbles thing with my 2yo DD now. DS doesn't seem to have a pattern to be honest. Sometimes he just shouts 'I'm off for a poo' always nice when you have company...and other times tells me that he can't go its too scary. i've tried sitting with him, not sitting with him. Talking to him, telling his stories allsorts...if there was a pattern I'd try to change it and I think thats what I'm finding hardest.
He does quite happily sit on a potty if his sister is 'occupying the seat' if you'll pardon the expression, so maybe that might be a way forward.

This problem should be seen for Paedriatric assessment and not treated in General practice. Ask GP or School Nurse for referral. The use of stimulent laxitives is not recommended in this case. Osmotic type is better which draws extra fluid INTO colon to soften stool - NOT FLUSH OUT HARD stool causing pain where there is a Viscous cycle in operation = Bowel movement associated with pain = Child holds stool causing stool to be harder and larger.
Meanwhile decrease foods LOW in fiber. EG Milk, cheese, Bananas, yogurt, cooked carrots etc.
Be mindful that milk isnt constipatory for most kids but may be for him. Increase following; High fiber fruit & vegetables especially raw. Any bran cereals, bran muffins, beans-any, sweet potato, peas, turnip greens & raw tomatos. 2-4 glasses of water or fruit juice daily - apple, pear, prune or any other type high in sorbital.
Also needs 5-6 grams of fiber plus childs age in years every day.

Wow Lillyaan thank you for that, the GP just told me to give him more fruit. That information seems well worth a try. Can I just call the school nurse regarding this. My daughter is under the school nurse for her weight (got a snotty letter telling me my DD was obese and gave me a healthy eating chart..not impressed by the high and mighty tone still, off the subject ahem) so I have the number somewhere.

PLEASE READ Constipation, Withholding and Your Child: A Family Guide to Soiling and Wetting. This is so so helpful.

An xray after taking markers for 3 days is really needed, this will tell you if he is conspitated. If so a horrible week of disimpacting then long term Movicol I suspect. You really need to be sure though what is really going on otherwise you are guessing.

Thanks eachpeach will look it up in the library.
I know I don't feel like they are doing enough for him really.

Have a look at " squatty potty" . Horrible name I know but they explain about problems with the sitting position on modern toilets very well. Putting my feet up on a stool really helps me when I have piles/ constipation issues. Much harder to withhold in that position too.

Daisy I could have written your post almost exactly two years ago. Exactly the same with ds, used to soil a nappy every night then it went to overspill constantly, appetite went down. Stomach pains and eventually it was just constant soiling with no large movements. Have they done an X-ray on him? This was the turning point for us it showed all the areas blocked in his tummy and it was quite high up, could have had these compacted stools there for a very long time.

They gave him a dose of Picolax, it is given before people are given operations in the hospital and it clears you out, and I mean completely, he sat on a commode in front of the tv for about 9 hours. And I could not believe how much there was, sorry tmi. Anyway that was about 3 months ago, we doubled his fluid intake and fruit daily and carried on using the movical sachets and slowly slowly we are now at the point where he goes to the bathroom an hour after his dinner, sits there for about 40 minutes bless him and have had a stool for the last 5 nights in 7 and is clean in the day. He is seven years old and this is the first week he has gone to school without a nappy, we are so happy we could cry. As mentioned by numerous posters he was tested for all kind of intolerances first, blood tests, stool tests etc so it would be good if they did this to put your mind at rest. Psychologically is a big step for them too after having pain the withholding is quite natural so we had to make it enjoyable and completely relaxed, he took his ds up there, music on, sometimes even a lollipop.

Sorry so long but I hope this has given you some hope, it is very distressing for both of you I know, be prepared that it may take a while but support groups like Eric are a great reference, as was mumsnet. Good luck and hang in there.

See other subject here re 97th centile. May explaine.

Daysie, hope you saw my post, think the above post was meant for another thread. Hang in there it is a long haul, since posting he hasn't been to toilet for two nights, aww, we thought we had it worked out but it goes to show you can't count your horses.

I did see it thank you ... i'm giving the movicol a go but if he doesn't settle soon I'll be back at the docs asking for an xray. Really hope your little one settles soon.