my child has severe constipation? when do I need to worry?

[RCunners123]

Hi, sorry I am new to this site and a first time dad to a 16 month old.

he has suffered with "constipation" since birth but as he's got older and started on solid foods it has definitely got worse.

sometimes they are like mush other times they are extremely big, hard and can cause small amounts of bleeding. but every time he screams in pain.
he strains multiple times a day without going (he usually has a poo between 1-3 times a day)

he has been to the doctors multiple times who have done basic checks on him and he's now on 5ml of lactulose twice and day and suppositories but these don't seem to be helping.

over the last 7-10 days he has gone from eating anything and everything to not eating at all and throwing tantrums when we even offer any food. we have managed to get some yoghurts and small things down him but he has only eaten one decent meal in the last week.

with the medication not working and lack of food I'm worried this may be something more serious (an allergy, or bowel issues) but don't want to keep going to the doctors with the same response of "its constipation, its common in children"

am I overthinking this? and not giving long enough for him to get back onto foods etc again or should I be pushing the doctors to do a more in-depth exam just to rule anything out?

I would go back to GP.

Please urgently seek more medical help. They could have faecal impaction, which can eventually back up so they vomit faeces. It can be very serious.

My daughter suffered really badly with constipation for years. I had no answers from anyone just lactulose etc thrown at us. In the end I stopped her having dairy and she's been fine since so it was a dairy intolerance. I think I'd be investigating food intolerances in your position tbh.

Lactulose worked really well for my DD but she was older so check with GP again
My HV had a tummy massage course that helped with young babies and constipation, again also very good but you must do this under supervision as it's complex and needs to be right and done the right direction

Is he drinking plenty and producing wet nappies? When my little boy was very poorly with dehydration and tummy issues he was barely weeing and the poo he was producing was chalky and grey. He was also vomiting any fluids we gave him. He got to such a state but the GP was just going to send him home "To do a fart". I insisted we needed more to be done and the GP reluctantly sent us to paediatrics, where were rushed by ambulance to Bristol Children's hospital and stayed there for 3 weeks with twice daily bowel wash-outs and laxatives to bring home. I would keep on at GP if I were you and insist on a referral x good luck!

Hi, thankyou for the response. we thought the same thing and wasn't sure how the doctors tested for this, he drink cows milk now and has mostly drank all of this.

did you change to soy milk?

@MrsT84 he never really drank loads of water/juice etc but always been good with his milk which he drinks and still has wet nappies etc

his poos are normal in colour etc he's just in extreme pain and they cause bleeding sometimes. this is the first time its really affected his mood through the day

i have called the doctors back and am awaitng a call so going to insist on something looked at further

That's good he is staying hydrated and wet nappies. We had to use movicol to help our son. We also saw a dietician who made him dairy and soya free for a year. He is a strapping 7.5 year old now with no issues or dietary requirements. I would insist on extra support for the pain and bleeding if I were you x

Lactulose is useless. Needs movicol/laxido. You might find www.eric.org.uk illuminating.

I would also strongly recommend Movicol. Lactulose did nothing for my little one. Movicol pretty much solved It

My son was similar at the same age and was put on movicol (low dose of one sachet per day which then decreased to half a sachet per day) for 2 years. He’s fine now!

It’s very distressing when they’re trying to poo and it’s agony for them though. I remember it well.

Movicol is much more effective and he may need a lot for quite some time (a year is not uncommon whilst the overstretched bowel recovers). I'd be insisting on an urgent referral to a paediatric gastroenterology specialist.

You need movicol/Laxido not lactulose. Look at the ERIC website or phone them for advice.

See another GP. I’ve found they are very variable in how seriously they take constipation. It’s awful for the child to experience and should be completely avoidable. Also agree the laxido/movicol is a must. Lactulose alone clearly isn’t working.

Agree with others. Lactulose isn't the best. Movical/laxido is best but it does taste vile so it's whether or not your son would drink it.
If you can, prune or pear fruit pouches may help. Mixed with yoghurt or weetabix or something.
The not eating may be unrelated. If he's not feeling well, this will put him off his food. My son had hand foot and mouth once and didn't eat a thing for 8 days. I was beside myself so understand the worry.
You and mum know baby best though. If you feel you need to go back to the gp, ring and ask to speak to a different gp. Some are more helpful than others!
Hope he's feeling better soon.

You need to look at the ERIC website asap and use their free helpline.