Constipation/with holding

[sazza040]

Daughter is 2yr old 3 months , been suffering with constipation for a while now. To cut a long story short , found out she has been with holding and have put her on daily doses of Movicol and Lactulose. Now the witholding is obviously worse than ever. Its been going on for a week like this now, I feel like I am losing my little girl. Its affecting everything. It has been to the point today where she wouldnt even leave her bed as she was trying to hold it in, she was trying to get me to leave her alone so she could hold it in peace. I cant bear her doing this to herself. Im trying to ignore it and its breaking my heart. Any one who's had experience to this how did their little ones cope when put on the medication- J seems worse than when she wasnt (but then shed eventually pass agonising bm which was also heart breaking).

Oh bless her. It would break my heart too.

What dosage is she on? My DD is the same age and has been on Movicol for a long time now. Not Lactulose though.

I'm not sure why they've prescribed both, but in my (fairly extensive) experience, Movicol will make the poo so soft, explosive even, that they don't have a choice to withhold it. They can't! Then, as long as the poo remains soft and easier to pass, the compulsion to withhold will go away.

Am assuming out of nappies? My son was fine in nappies, but held on a bit on the poo front once out of nappies. Not to this extent though. I found that a kiwi fruit a day really helped with any constipation. Not sure if helpful...
There was a story I used to read my son whilst he sat on the toilet trying/doing a poo - it was on the internet - here's the YouTube version... but I had it downloaded as a readable version (will attempt to find for you).

Thanks for replies. Shes still in nappies and shes taking Lactulose, 10mls in the morn and 10mls at night plus 1 sachet of Movicol but Ive upped this to two sachets of Movicol as of yesterday as 1 wasnt helping allot. She's only been twice in the week, once 3 days. Today was day 3 and she did some by accident in the bath (...ick i know!!) but even that wasnt all of it as she is still clinging on to it for dear life. Ive spent a miserable day with her - half of it she spent on the floor with bright red cheeks and therefore she cant give her attention to anything a 2 year old should be :(

Try showing her the YouTube thing... it's about getting poo out and letting it go back to it's family where it'll be reunited with all the other poo's. Odd I know, and I spent ages on my knees reading it to my son from my phone when he was on the toilet, but it helped him, he was keen to reunite the Poo Family! You never know.

I would say she's too young to be reasoned with ChilliQueen. YouTube vids would be fine for, say, kids aged 3+, but I know my DD wouldn't really follow a narrative like that just yet.

In my experience Sazza, Movicol is much more effective than Lactulose. I also doubt that one sachet is enough in a situation like this. My DD is on two sachets a day just as a maintenance dose, for example.

I would carry on with two or even three sachets a day until she's pooing daily and without withholding.

Would you consider a glycerine suppository even? I'm not sure if infant suppositories have to be prescribed or if you can buy them OTC. The fact she's fighting not to poo all day long is just horrendous and it can't carry on much longer.

Ahh yes the suppositories- we tried them before the movicol and lactulose- thats contributing to the fear now as she will barely let me change her nappy as she has lost trust in me completely. I cant imagine her not witholding as shes carrying on- she is still awake now as too fidgety and uncomfortable. Will the movicol build up then and make it impossible for her to hold it in every day then? Im hoping something like that will happen- she hasnt even been waking up till 10am because shes too tired from holding in the night before.

Sorry, is she actually constipated or just holding it in and therefore in everyone's eyes constipated? There is a difference Obviously holding it in can cause lots of problems including constipation. Kids can be scared to poo. If she's taking everything you say she is, then poo should be flowing. She must be in absolute agony holding it in. We had (and even now age 7 have) a few poo issues, so can you chat to her, talk about poo, everyone pooing, how nice it is to get out etc, it's not part of you etc. Gosh... clutching at straws a bit, but everyone poos etc. I feel for you. Just talk about poo lots...?

Shes holding it on, first we thought just constipated often (that was bad enough) but now leant she is holding on to it. Yes, she is really suffering she go's bright read and sweaty trying to keep it on. Im not sure the dosage is correct- The GP's have been pretty useless to be honest :(

You can adjust the dose according to your own judgement then. Movicol is safe - if you give her too much the only result will be diahorrea, which is preferable to what you have right now.

I would stop the Lactulose as well. Movicol on its own is enough. Lactulose is just a stool softener. Movicol is a bulking laxative and a stool softener.

Is she drinking the Movicol ok? Like I said, at this stage you can get away with giving at least three sachets a day to clear the backlog. Poor girl must have a sphincter of steel to hold it for so long.

And go back to the GP if she doesn't poo properly this weekend.

Thanks again for messages. Any input is appreciated. Last night the poor little thing let go of it about 10pm, I was updating my mum on the situation just outside of the room (and heard dd desperately cry 'Mummmy'), came back into the room and she had taken her nappy off and there it was on the floor!!!! :/ Of course I made a big fuss of her, gave her 3 chocolate stars etc as I have been the previous few times she has been. I have been hiding the Movicol in a little water in her morning chocolate milk (she has soya milk now though). Her mood is much better today although she is generally acting overtired from the days of holding it in. She is still holding something as ive seen her do it a few times but obviously not as she was y/day. Im guessing it will just take time- but Ive read that for in order them to trust going again they need to have atleast 1 bowel movement a day- I have NO idea how she will ever go every day how determined she is . Cant help feeling like a failure and I have images of her school age with these issues and soiling problems :(

Id just like to add, im not sure what is causing it but i suspect the primary cause is that it has hurt her to go previously. She has also become , in the last few weeks very aware of wee's and poo's- she knows her brother and her go in nappies but we go in the toilet. Husband has a bit of a sensitive nose to nappies- Im wondering if he's embarrassed her out of them if she's done a smelly one or if she is stuck inbetween- not wanting to go in the nappy or on the toilet :(

Don't blame yourself, it's SO common. Chances are, she started withholding because when she was constipated, bowel movements were really painful. So she decided she wasn't going to poo ever again!

Keep up with the Movicol long term. I mean very long term. My DD is 2.3 and has been on it daily since 7 months with no sign of weaning her off. She sees a consultant every 4-6 months or so.

Not sure how useful your GP will be, but you can always ask to see a gastro if you think you need to.

Thanks :( I blame myself although I read its common as she has passed such large painful ones in the past. I have been to the doctors several times and I feel let down by them to be honest. They had given me no real advice or even told me how to distribute medicine. The first few times I have been they have just prescribed more lactulose to be taken 'as and when required' and when I asked when should i give It to her they just said when she needs it. Ive found most of the information on the internet! Im suprised the dr's dont take it more seriously. Shes my first child and I had no idea what to look out for- the sounds when she was holding in etc were similar to when you are trying to go- shes been doing it off and on for maybe a year im guessing. When the penny finally dropped it seemed so obvious but hindsight is such a wonderful thing. From what I have found out myself it is a slow process- and Im happy to give her the Movicol if it keeps her pain free. Ive pushed the doctor to a referral now so waiting on the appointment. Has your DD stopped holding it in now?? Has it improved at all now after the 7 months of meds??

My 2.2 yr ds has movicol twice a day and also sodium picolsulfate twice a week to keep his bowels moving. His is constipation due to a medical issue but 1 sachet a day of movicol doesn't sound a lot for your dd. In case the doctors haven't said, it is best dissolved in milk as it tastes horrible otherwise. We make a point of making every poo my ds has done positive, only laughing at any smell and I always say 'better out than in' to him.
I hope you get a referral appt soon.

Thanks, im thinking of cutting out the lactulose- didnt seem to work before and upping the Movicol. It seems like trial and error (am also working on high fibre diet) , dd has picky days like most toddlers. I had upped to 2 movicols for 2 nights and last night she had 3 movicols (plus the lactulose) and finally went in evening (was the third night) and again this afternoon. Im thinking I should probably give her 3 a day but Im not sure. Im reluctant to use Lactulose any more due to further research I can not see advantages for using them both.

I know the movicol softens the poos but I think that lactulose does the same thing so might just make it very loose? Are you spreading the movicols out across the day? From your wording sounded like all 3 are being given at night but I could be reading it wrong. I give my ds a sachet in his morning milk and another in his bed time milk.
I think toddlers can't process too much fibre like bran and brown bread etc but fruit is very good for making them go. Grapes, kiwis, strawberries and mango all work wonders on my ds. We avoid too much rice and banana. Weetabix not meant to be good either altho my ds has been ok with this. A good fluid intake through the day helps and a little sugar actually helps the gut so I think the natural sugar in the fruit helps.

Thanks. Willing to try anything. We've had another awful day and I feel like I dont know how much more I can take! Its absolutely dreadful. Gave one sachet in eve and night and all day today has still been spent holding it meaning only eat lunch and none of her dinner its difficult to get fluid into her when all she will do Is lie with her legs tightly crossed. Its a nightmare and It really is breaking my heart.

Something must be hurting her surely when she poos? She's too young to withhold for any other reason? Do you let her come with you into bathroom when you go to the loo and explain what you are doing? I do with my ds as I'm so paranoid about him associating poo negatively as he's in and out of hospital for it.
I really hope things improve soon for you, it's horrid seeing your little one in distress.

I think you'll find it helpful when the referral cones through (chase it if need be). You can discuss dosage etc with the consultant. GPs aren't necessarily that knowledgable.

Personally, I would stop the Lactulose. Movicol alone is enough. Also, there's no need to spead the Movicol sachets out during the day. If anything, they're more effective taken as one big hit.

So, for example, I give my DD two sachets in one drink of juice every morning. It usually takes her a couple of hours to sip it all but that's ok.

Thanks for your advice, I have stopped the Lactulose. Am now trying with Movicol alone, spoke to ERIC charity and they have advised doing the dis impaction but obv need to speak to DRS first. They say its on the guidlines. It seems like she has forgotten to do anything but hold on at the moment, im hoping there will be a light at the end of our tunnel.

It is a long tunnel - effectively you have to make her poo so runny that she can't hold it in. She holds it in as when she was constipated it was painful to go so she thinks if she doesn't go, it won't be painful but of course she's making it worse.

During the time she's been constipated the bowel has got dilated. So you need to give her enough Movicol to make her poo runny so she can't withhold and then keep doing this for ages. You can then cut down the Movicol a little but stool still needs to be a slurry consistency for months to let her bowel recover.

Just giving it 'as required' perpertuates the cycle as she goes, it's hard, she withholds again.

You are going everything right by upping the Movicol and doing it every day but it's a very long haul job, don't be downhearted.

Thanks. I guess I feel like im stuck in a weird paradox - ofcourse she needs the medicine to stop her getting impacted and keep everything soft but obv the more she needs to go now the more she is witholding it- she is then withdrawing from herself and not the little girl she is once shes had a poo. Im really concerned the effect this will have on her delvelopment and mental state.I guess this must be a sign she is not having enough of the movicol. GP'S useless in his department- oursuffering seems to mean nothing. What im worried for atm she is spending her days just holding in every day and not eating or sleeping therfor...the drs make it sound it so simple that make the poo soft so she can go but she is holding it in even though it is soft. Thanks so much for replying,...

I totally get where you are coming from, would it help to think about what you can remember from when you were that age? You can't remember much if anything. When she is grown up this will be practically forgotten, even by you.

I'd just stress that the poo needs to be beyond soft - soft she can still withhold. You are aiming for runny and mushy (if you google the Bristol Stool Chart what you want is a Type 6). So you need to increase the movicol until it looks like that. And lots of reward to her for having a poo, even if it was on your lovely new sofa. Somehow you have to make having a poo the funnest, most rewarding and fabulous thing she can possibly do.

Hi, how long has she been on the movicol for? My daughter who is 3 and a half has been on lactulose for ages, she initially was constipated with really hard poo which the lactulose has sorted out but was withholding and only going about once a week.

It has taken me about 4 GP visits and my health visitor getting involved to get the movicol, up till recently they just kept fobbing me off with more lactulose. I was told just what Kundry has said about needing to retrain the bowel. In the 2 weeks since we've started the movicol we have progressed to a poo every 1-2 days but still not wanting to use the toilet, all but 1 have been during sleep or an accident in pants.

Is it ok to give the movicol in milk? I was told it had to be in water and the last couple of days it has been a real battle getting her to drink it, I have added a bit of squash before but think she would take it much better in milk.
(Sorry for hijack)

My girls not a drinker either. As far as i have researched you can take it in milk, (so long as you add the water)i make it up in my dds morning milk by mixing it with some water first then adding it to the milk, she has soya milk with nesquik and cant seem to taste it. I didnt know before you can give double doses. Doctors have been fobbing me off with lactulose for months too :@ Lactulose has been useless in my experience.