is this chronic constipation?gp not taking me seriously

[amirah85]

DD is 4.5,we had some problems for about a year,started with some wetting(not full on accident) then soiling.mostly is just a bit of poo,sometime quite a bit.been to gp ,he felt her tummy and said nothing wrong there?eventualy got some lactulose and things improved but now gone bad again :-( thing is she does go to the toilet every day,sometime more then once,even tho it doesnt seem to be a full BM iukwim?i dont know if its just a behaviour thing(not wanting to sit on toilet for long time) or chronic constipation.shall i take her back to the GP?any tips on how to teach her to go as soon as she needs rather then wait till she finishes the book/game/coloring??thanks

Hello. Our DD 5 has problems like this. She has never been completely dry since potty trained at just under 3 and also has soiling problems. Our GP felt her tummy and didn't feel anything and gave us lactulose to try but the problems got worse and eventually we got seen at the hospital. She had/has an impacted bowel. I think you do need to push to get a referral from your GP. DD also has an irritable bladder and the medication she's on for that causes her constipation too. Oh joy.

Good luck. Don't be fobbed off. This problem can ruin family life and needs proper attention.

The only reliable way to diagnose impaction is an Xray.

Feeling the tummy is notoriously unreliable.

TBH it does sound like impaction with overflow.

Have you looked on the ERIC website?

i did look on the eric website,it just seems strange that she can be constipated but goes a few times a day,even tho just a little bit?

You have my sympathies, we've been going through this since potty training DS and he is now six. Our GP kept dismissing it and saying he'd grow out of it and we had to keep going back until he eventually referred us to a specialist at the hospital. DS's tummy has always felt normal according to the doctor and he goes for a poo at least once a day so I couldn't believe it could be constipation/impaction but the specialist has recently prescribed laxatives.

DS is still wetting and soiling daily but at least I feel as though we are hopefully getting somewhere since being referred to someone who is taking us seriously.

Sorry for long post! If I were you I'd definitely go back to the doctor and ask for a referral.

It needs treating by a specialist not a GP. I agree it needs an xray not feeling the tummy. My DS would poo several times a day but was still very impacted.

He is now under a leading gastroenterlologist and has now been on a mix of movicol and sodium picosulphate for several years but the damage caused to the rectum by the delay in diagnosis and treatment has still not repaired and may take years more.

It needs taking seriously as it can cause long term damage and needs a proper investigation by a specialist.

Dont worry about the difference between behaviour and constipation but install a set routine to sit on the toilet after every meal for a set amount of time (with book or similar). Get the child to try even if they say they dont need to go. We still have to do this several years after diagnosis as all sensation was lost in the rectum.

How long shall I get her to sit on the toilet?I don't want to make it into a big deal and make it worst iukwim?as well anything I can do regarding diet?reduce diaries etc?she eats very well,vegs and fruit no prob,even tho she likes crap too(choc and crisp) but I limit those

DS still sits on the toilet for 10 minutes after every meal and at least 5 minutes before and after bath. This prevents accidents in the bath as the warm water used to result in accidents and immediately after as that is when he is most likely to manage.

If DSe says he doesnt want to we always say he doesnt have to do anything but has to try and there is no negotiation even if we are out we follow the routine. After 2 years he generally goes without a tantrum but we always use a kitchen timer so he has a 5 minute warning in advance of going and then a timer for the duration but am sure most children will get the routine far more quickly!

He always reads on the toilet but if she doesnt read then anything colouring/computer game/you reading to her/story tape on ipod. All professional advice we have been given from everyone even the most useless all agree on this one point that you have to get a toileting routine after meals and eliminate the stress and battle of trying to get them to go.

The other thing everyone agrees on is drink lots of water - this is essential.

DS has had not sensation of needing to go or even feeling it coming out so we just have to manage it for him and now after 2 years there are times when he can feel it coming and gets to the toilet on time unprompted!

All advice we have had is not to alter diet initially only on the advice of professionals and initially try to manage it with the routine and movicol and if this doesnt work then investigate diet but only under a proper professsional. DS is under a gastroenterologist. We found GPs, incontinece clinics, paediatricians a total waste of space but cant recommend gastroenterologist enough.

Happy to help further

Thanks a lot,I have an app booked for her at GP next week,will see if I can manage to make him take me seriously!

Going a little bit several times a day is a classic sign of impaction. So is runny stools and incontinence.

I hope you get a referral asap.

well been to the GP and guess what?he checked her belly again gave her lactulose again,said she can keep taking it more or less forever and whan i asked about x rays apparently u cant see anything with that,only bones .....somehow i dont feel too happy about that...

That is nonsense about the Xray. Of course faecal impaction is visible on Xray.

Can you see a different GP?

go to a different doctor. ask for the children's continence nurse.

as others have said, the longer problems go on undiagnosed, the longer and more difficult recovery is.

good luck

Go private if you can possibly get the money if the NHS wont help. This can become a huge problem especially when happening at school and can cause long term damage to the bowels and huge mental distress to the whole family especially to the child when the teasing starts.