Chronic constipation - did you find a reason?!

[WillowB]

DS aged almost 3 has been suffering with constipation since last Dec. We initially followed a laxido disimpaction regime then went on to a maintenance dose of 1-2 sachets a day. All seemed well, stools always fairly loose with the occasional spell of him being a bit uncomfortable

Sorry posted too soon!!

Anyway had a really bad relapse in July, had to take him to a&e as he couldn't pass urine as he was so badly constipated (we had already upped his laxido to no avail)
Now on a maintenance dose of 6-8 sachets per day and he's still getting constipated. Saw a consultant 10 days ago who said cut out his 2 daily beakers of milk & that will sort it. He's actually got worse and even with 10 sachets of laxido, and ducolax is in a huge amount of discomfort today. Can't (or won't?) go and is crying and in pain.
I'm at my wits end with it all. Can't up his laxido any more as he just won't drink that amount of liquid. There seems no obvious reason either as he has a good diet, plenty of fluids etc.
Any advice or experiences appreciated!!

Did you potty train too early?

No...! I haven't even attempted it as I think it will complicate things even further

I think you need to go back to the consultant and explain things again, and ask how long before you should be seeing results after taking his/her advice regarding changes to make.

Milk can cause lots of constipation and so can certain foods, so it could be that he is really bunged up and needs help properly emptying his bowel before you’ll notice any improvement.

Hi my DS is 3 on laxido has been for years he is always getting bad episodes aswell where he’s only needed 2 a day at most I find bananas make him worse, maybe try not giving any if you do? Where having review with paediatrician next month as he eats loads fibre only drinks water and he still gets so bad sometimes he cry’s with pain I am asking for further testing regarding it,

If it is a won’t go instead of can’t then woth looking at a book called the sneaky poo, talks about anxiety about going that may help. But clearly need to rule out all physical causes first

My DC was badly affected by cooked carrots. Pears were great for keeping things moving. Probably not the same food triggering constipation, but could be worth trying to find the culprit (s). Do try pear as a way of keeping things soft.

I’ve had a major experience of this. My daughter would struggle to go and the worst episode was 17 days of her not going at all.
We were given all sorts, lactulose, laxido, prune juice, califig. It was awful and still nothing worked.

This bit gets a bit ‘to much information’ so apologies in advance...

One day I realised that her poops were so big that they were getting stuck coming out between herself and the nappy. Basically the nappy was hindering the poops exit which caused her pain so she was stopping herself from going/finishing. I took her nappy off and let her continue going which she did with much more ease as it was no longer getting stuck. Next time she needed to go I removed the nappy and again no problems. She pooped everyday from that moment onwards without any problems as long as the nappy was off!
I know it sounds gross but I thought I’d mention this just in case it’s a possibility with your little one.

If he might be in pain from constipation atm, and he will eat licorace let him at a couple of pieces at a time, pref just licorace on its own not allsorts. It works as a natural laxative.

Or also recommend Milk of Magnesia but i think licorace presented as sweets that will help him go to the toilet easily might be best.

I had chronic constipation and impaction when i was 8/9 year old, i ended up with poo nurses coming alternate days to do manual evacuation -

I ended up having an operation to stretch out my back passage as while I had grown, for some reason it hadnt and was still approx the size of a 3 year old, they basically stretched it while I was under GA and I passed BM easily to the delight of family, hospital staff and me. No pain involved and I hadnt a clue what had really happened the day before.

I had had literally everything constipation wise to help me go before that a child could have to no avail.

We've also had experience of this. For approx 4.5 years my now 10 year old Ds has had constipation, including dreadful episodes of sobbing in pain on the loo.

He's had maintenance movicol for months and months, two or three disimpactions followed by maintenance etc etc.

We've seen a great consultant who listens and I think understood that he does eat a really good diet, loads of fruit and veg, pasta with added fibre etc.

So in Jan, under an Nhs dietician he went on a 8 week exclusion diet....no dairy, wheat , soya or gluten. Symptoms I.proved radically in about three weeks. Through reintroduction we have learned he has a dairy intolerance causing IBS.

We were actually delighted to come to this conclusion, as we can control it.

Oh....I should also say he had lots of tests to rule out crohns, colitis and other bowel issues.

Gosh, I can’t believe he isn’t going with that much Laxido in him. Do you think he’s withholding? Although I’d be surprised it’s even possible to withhold so much liquid stool.

I have two children on Movicol (same thing) and also need to take it myself (although it took 30 years of badly managed chronic constipation before I realised I needed a daily stool softener). I do wonder if there’s a cause beyond “sluggish bowels”. I’ve never asked, or wanted to submit myself for any horrible tests.

One other thing...my DS has hypermobility which I've heard can make your bowel more elastic and harder to empty....But doctor was never concerned about this so not sure really.

There's a good book ..constipation, withholding and your child

Thank you to everyone who has taken the time to reply, it's really helpful to hear other people's experiences. It seems a trivial thing to talk about with friends & family but it's having a massive impact on DS and our family.

Some interesting food for thought - my brother and nephew are both dairy intolerant so maybe worth me trying to exclude that to see what happens. I did ask if DS could be referred for blood tests but was told that they only look into underlying causes if the child doesn't respond to treatment - he's been on laxatives for 8 months fgs!!!

My older DS has hyper mobility/hypotonia which he sees a physio for. interesting to see that mentioned. Had presumed DS2 was unaffected as he has better gross motor skills but maybe not.

I'm not sure either how much is psychological now with DS holding them in until he virtually explodes, then gets really distressed and so the cycle continues.

Anyway we've had some 'poovement' tonight which is good. Fingers crossed for a better day tomorrow...

Ooh and thank you for the book recommendations. Will have a look

Good luck OP. no one gets the massive Impact it has on the family til they've been through it. Hope it improves soon.

@WillowB Hi, how is your family getting on? I say, family, as this doesn't just affect your son but also you and other family members.

@krisskross good thinking re hypermobility and constipation being connected - here is a link hypermobility.org/help-advice/bowel-problems/

Best wishes

Thanks for posting @smurfy2015
Things aren't too bad at the moment, fingers crossed!
I've been doing some more research and have decided to try cutting out all cows milk to see if it makes a difference (My brother and nephew have a cows milk allergy). It's been a week now and although there hasn't been any sort of dramatic change DS is definitely less bloated & windy. He's still occasionally complaining that his bottom hurts and trying to withhold but we have had a decent sized movement each day and has been happy in himself.
I've tweaked his laxatives too so that he has his dulcolax and laxido first thing in the morning as his usual time to go to the loo is late afternoon.
We're on our hols at the moment so I'm hoping it lasts at least until the end of the week!
Thanks for the hypermobility link, interesting. I will raise it with the consultant when we next see him.

Thats good, as an aside with "his bottom hurts and is trying to withhold", if it might be worth a trial before and after he tries to go, some nappy cream (own brand is fine) or vaseline around his starfish, it eases things -

no need to be specific on area just a blob in general area, moving around will work it into the right places for him. It means eases things out, if hurts then another blob to take away soreness.

Tip - put a plain label over the tub of nappy cream of X (child name special/ magic botty cream) - something he will believe in

Im currently using this myself as I have itchy piles

Starting to piece it together with DD2 at the moment (she's 5)... she has dyspraxia and I don't think could actually figure out how to DO a poo rather than it just happening in a nappy until we explained the muscle movement involved (in a "try pushing your tummy button out of your bottom" way) and also apparently has very very low muscle tone which hasn't helped matters either. Also probably still some slight dairy intolerance.