Constipation and refusing to drink

[PodeTheBogeySlayer]

My 3.5 yo DS1 had an inguinal hernia which was fixed in June. In the months before, he would get really upset because it would pop through (the size of a golf ball) when his bowels were full and when he was straining on the toilet. He seems to think this is still going to happen, after surgery, as he is convinced he can't poo because it will hurt and so he just holds it and holds it.

He keeps having mini accidents (we call them mucky smudges) where it's clearly forcing it's way out and he's holding on, but can go for days without doing a proper poo, sometimes a week. And then it's the size of an adult poo, pretty much filling the potty (he uses a potty and the 'big boy toilet', he gets to choose which he wants to use) so of course it's going to hurt.

I booked a doctors appointment but had to wait a while to see the right one (as had seen another gp and his advice didn't work so wanted to see my trusted favourite gp) and in desperation during the wait I gave him lactulose which I already had in (which I know you're not supposed to give but as I say we were just desperate to help him). He was complaining about feeling full all the time and having a hurty tummy. I 'hid' the lactulose in chocolate milkshake and it worked after a day or two and he seemed to be back to his normal self. I didn't mention that being constipated has turned him into an absolute grumpy nightmare.

We were prescribed Movicol which I have given him a few times, but the problem is that he won't drink it. I'm sure another part of his problem is that he doesn't drink enough to the point of almost dehydration but I can't force him to drink. We've tried juice (watered down and as it comes), squash, Capri suns, the only think he wants to drink is milk and I can't mix the stuff into that because it tastes horrendous. And I'm not convinced it gives him enough liquid. He's also naturally suspicious of anything I give him to help him poo and tells me he doesn't want to poo. He eats fruit sometimes but I think he senses my pushing it and then gets suspicious of that too. He does wee a few times a day but it seems really dark and again he holds and holds this for ages until I force him to sit on the potty.

I just don't know what to do. I need him to want to drink and want to poo. I think I'll just have to go back to the gp. Sorry for rambling post but I'm just so worried.

Your poor boy (and you) - constipation turns the most pleasant and amiable of us into grumpy monsters.

In terms of getting him to drink more, I've found two things that have worked with mine 1) Ice cubes and straws. The ice cubes in particular; he loves helping me get them from the freezer, putting them in the drink and then downing the whole thing. I don't do it all the time and save it for constipation. 2) A new cup. This has worked accidentally, by that I mean whenever we get a new cup there's a novelty period of very enthusiastic drinking! Oh, and Innocent fruit smoothies are good too. And going in bath (although I never want that want to be drunk, it always is!)

Could you try a new toddler seat for the toilet, saying this is a special new place for you to do poos where they won't hurt and you won't need to feel worried. The idea being that it breaks the negative association with the normal toilet/potty. Then hang out sitting on the new toilet seat reading, watching videos, whatever - but FUN stuff so that he's relaxed. No pressure to poo, but hopefully one'll come long at some point and it won't hurt and he can start to feel ok about it again.

I'm no expert on anything like this, so these are just thoughts based on my experience with negotiating with toddlers. Sorry if it's useless!

I really hope it all settles down soon for you, it sounds exhausting.

You can mix the Movicol into a really tiny amount of water and then mix it into anything - yoghurt, custard, smoothie. As long as you follow it up with enough fluid it really doesn't matter that you didn't prepare it as advised on the box.

You can mix two sachets into half an eggcup of water. Just make sure you stir really well and leave until completely dissolved.

Will he eat ice lollies?
DT2 was dreadful but he would eat pear (supposed to be really good) and we had a game of eating water melon on the back step and spitting the pips as far as poss. I have no experience of Movicol but could it be mixed into water then jam to make a syrup to stir into yoghurt?
DT2 would always be bribed with a fruit shoot too.
Good luck. It's nasty having a kid with poo problems.

Movicol works best in water rather than milk but still ok to give in milk if can't get it into child in water based drink. This is what my ds surgeon says - he's been on Movicol for 2.5 years and likely to be on it forever. Chocolate flavour nesquick works well to hide the flavour. We mix it in milk for morning and evening doses and in the day he has it in squash. I've used different straws, cups, bribes, drinking competitions, you name it to get my ds to drink who is also a bad drinker but has a medical condition which means he can't poo. good luck

Thank you so much, I thought I'd get a notification of a response so I didn't realise I had so many replies.

Jessbags, thank you, have sent DH to get a new cup on his lunch break and I'll put some ice in the freezer now. We've tried with a new toddler seat (Lightning McQueen) and he does use it, I think we did try to say it was special for helping to poo without hurting but that only worked until the next time when it did hurt. We've also tried sitting him in front of CBeebies or playing his spelling games on the iPad, but rather than being distracted into relaxing he just concentrates in them soo much!

Thanks for the info, I'll try mixing Movicol with other things and see if that works. The issue with DS is that if he's suspects that there's something different going in then he shuts down and refuses it. Because he thinks if you're helping him to poo it'll hurt and he doesn't want to let that happen. So times when things have worked and I've said "brilliant, well done that XXX has helped you poo" he then remembers and doesn't want that thing, because he doesn't want to poo.

It has gotten to the point a few times when he'll have accidents in his sleep because that's the only time he's not holding it. He's always been dry at night, right from the start of potty training, we've never had an accident until the pooing stopped. It's such hard work.

We went for a walk with friends I met at Antenatal classes on Friday and I worried at one point that he was doing a poo (he stands a certain way) and I said "oh no he's trying to do a poo" and the response from my friend was "what? In his pants?!?!" Made me feel like crap. Had to explain that he's really struggling and will hold it for a week and we're really worried about him.

The psychological side of things is really difficult.

If you manage to get enough Movicol down him though, he physically won't be able to withhold. It won't hurt either. The consistency to aim for is like mushy peas (or so the consultant told me!). It will be a battle but will really help in the long run.

Have had absolutely no luck getting the Movicol down him but he seems to be drinking more water out of his new cup, and just generally because I think I've stopped being so pushy!!!

Also actually paid attention to the advice of a HV to put him in a nappy to poo (it's still technically toilet training because he's thinking about when he needs to go) and so he's starting to poo without crying. And I have a friend who's little boy has the same problem and she was given the same advice (same HV) and it's working for her too. I've decided I need to stop worrying about the fact DS2 might be potty trained at the same time (2 years younger!) because actually it doesn't matter.

My Movicol child is 3.2 and not potty trained. You just need to put that to the back of your mind until their bowels are sorted.

Tough cookie with the Movicol refusal though. Have you tried mixing it in yoghurt/custard/whatever like I suggested earlier? Will he still not drink it if you give it first thing when he's thirsty? Bribery? You might have to get a bit tough, because he can't go through life refusing medicine when he needs it!