4yo permanent constipation

[Spainintherain]

Please can anyone advise how I can help my 4yo who is constantly constipated. She drink enough water or barely any vegetables. I have bought fun straws and new cups, tried fruit in ice cubes. She cries hysterically if we give lactulose very slowly and the GP prescribed movicol which was worse as she was crying and gagging.

I have tried hiding movicol in food but there aren't enough opportunities in a day for me to give it to her/she Doesn't finish that good to benefit from it.

You need to look at the ERIC website and call their help line.
Also, google the Poo Nurses and watch the video.

They are the experts and will be much more useful than the GP.

Are you giving stewed fruit, prunes, vegetable soup, figs, cooked carrots? These things all help. Califig syrup is good and tastes ok.

Have you tried adding more fibre to her diet? Maybe Weetabix for breakfast

What's her average daily diet like? We may be able to suggest some tweaks.

Does she like juice?

Ask to switch the Movicol to lactulose, it tasted much sweeter and can be mixed into juice. That’s how my daughter takes it- 7.5ml a day

We get a sachet of movicol a day into a cup of milk for my 5 year old without her noticing.

Which Movicol are you using (flavoured?) and how are you making it?

Mine gets a sachet of movicol mixed with some squash. She drinks the 60ish ml then gets a fresh cup.

Thicker drinks will hide the movicol texture. Maybe try smoothies or milkshake. It’s very important to persist with the treatment. One of my children was hospitalised with impaction. Our nutritionist afterwards told us that the main thing to focus on is liquid intake to keep the bowls moving. Some foods can help but water / liquids is what makes the largest difference.

Movicol can go in juice aswell as milkshakes or yoghurt

Mine have laxido. I mix it in to their morning milk and they have never noticed!

Would your daughter be interested in Weetabix? They do different flavours now, banana or even chocolate. I know they are high in fibre which may help. Also orange juice, I'm not sure if it would be recommended but an old school HV suggested it once and it does help.
Can you try mashing up fruit in yoghurts etc? Or as other posters have suggested perhaps smoothies and milkshakes. I would seek further assistance perhaps with your GP or HV with this though (we had a long bout of constipation with our DS) and if left it can cause a 'lazy bowel' best to get her checked out.

She is autistic and has restricted diet. She eats porridge at the moment. I tried mixing lactulose in but it's not worked as we are on day 6 now with just a few tiny poos in that time. Her lunch and dinner is either pizza, pasta pesto, chicken fajitas, burgers and chips, nuggets, some other meat, bread, not much vegetables other than bit of corn or carrot that I make her eat.

I make different veg at lunch and dinner and she won't eat it or soup.

I will try giving her juice with movicol added.

So if I add movicol to her porridge or yogurt etc it must be mixed with the 60ml water first?

Thank you!

Assuming movicol works the same as laxido then yes, you must mix with the recommended amount of water first but then can add it to anything

Is movicol flavoured? We have plain laxido so I think it's easy to hide.

The movicol we were given is plain.

You can mix Movicol with anything especially the plain version - juice, make her porridge with it, mix it in milk, squash.

Lactulose is so sweet it's horrid and practically impossibly to hide.

You can't put movicol in food, well you can but it won't work. It has to be mixed correctly in clear liquid, squash is ok but milk isn't and yoghurt definitely isn't. Also, dairy will make the constipation worse so avoid milk, yoghurt etc. Is there anything she'll drink? Keeping their fluid intake up is very important.
You need a proper assessment for her from a paediatric bowel consultant. My 6 year old son had chronic constipation which led to impaction and we are constantly managing and tweaking his medication so I know how hard it is. Eric are also helpful but it sounds like she might need more than movicol if things have been bad for a long time. Movicol and laxatives have helped him massively. He has a genetic condition that has autistic traits so I sympathise with what you're going through, it's awful watching them struggle and feeling like your lives are ruled by pooh or lack of it.
Please push your GP for a referral. Good luck.

Lactulose is super sweet!
It's also so mild that it'll have little affect on severe constipation

I seem to remember being taught that this is very common in children with autism.
Talking to ERIC would be a good first move. They can advise you about getting a referral.
I know it is unorthodox, but sugar free sweets and chocolate are very effective instant laxatives. Not as a regular thing, but they get things moving.

Hi OP, Was thinking about you as I mixed my son's movicol this morning. Have you tried increasing the movicol sachets by one a day for each day she isn't poohing properly? Although if she doesn't want to drink it that probably isn't helpful. I'm trying to think of things you can do while waiting for a possible referral.

Mix her movicol up and Put it in the fridge disguised in milk or a drink she likes leave it lying so she sees it and then she might become interested and want or not be that bothered by ir being a "new" or "strange" thing.

My autistic grandaughter had chronic constipation. To cut a very long story short, it was caused by cow milk and lactose intolerance.

In most people, lactose intolerance tends towards causing diarrhoea, not constipation. However in her case it was an atypical reaction. Sadly, a lot of the 'cures' for her constipation actually contained lactose, and she was in a lot of pain.

Another thing to consider is that autism has a strong co-morbidity with ehlers danlos syndrome which can have implications for gut mobility. Something to keep an eye on.

I mean t to say you do need to mix it with the proper amount of fluid for it to work.

Thank you all so much.