Child constipated after surgery

[SallyWD]

My son had surgery on Thursday and has been constipated since. I think he last went on Wednesday so it's been 4 days now. I know many suffer for much longer but today he's been utterly miserable. He's tried to go to the toilet several times and passed a small amount but is still very constipated and uncomfortable. It was so painful when he tried to go that he's now to scared to try again. He had urological surgery so can't really strain because it hurts his wounds.
I went to the pharmacist today and they gave me lactulose which they felt was the best option for him given his age and recent surgery. I've seen it can take a day or two to work. He's really suffering! Can't even sit down because it hurts so much and doesn't want to eat.
He's taken the medicine and I thought I'd take him to the doctor tomorrow if he's still suffering. Is there anything else I should do? He's drinking lots of water. Has anyone been in this situation with their child?

I should add he's a very fussy eater so I don't think he'd eat prunes or anything. Also he's just not wanting to eat (even his favourite foods).

Water and lactose do help. Have you tried very high fibre foods eg all bran, dried apricots, figs? What about senna or movicol? Is he on opiate based painkillers?

Worst comes to worse he may need a suppository.

I'm on dihydrydecodeine atm for a broken arm so I can sympathise.

Lactulose not lactose

Sorry x posted with the prunes suggestion

Thank you, I've been trying high fibre foods but he's really lost his appetite. He's only on paracetamol and ibuprofen but I've heard the general anaesthetic can cause constipation.
The pharmacist would only recommend lactulose for him but I'll ask the doctor about other options.
Hope you feel better soon!

Definitely go to GP. It’s great you’re taking it so seriously. Untreated constipation in kids can set up subconscious withholding which sets up a terrible cycle of further constipation.

My DD has been on Movicol and a bowel stimulant for years but as this is post-operative, you’ll need to see what GP says. Great he’s drinking water. Keep that up.

It can be common after anaesthetic and can take days to resolve.

Lactulose is all we'd give offer surgery, sometimes senna if it's really bad. But stick with the lactulose.

The GP would probably give movicol which wild in the same way as lactulose.

Would he eat soup?

Something containing veg and pulses along with the liquid, either home made or a supermarket fresh soup.

Sodium docusate was amazing for my DD after major surgery last year, anything else just gave her major tummy cramps and nausea. Getting up and walking around as much as possible will also help to get things going but I appreciate that might be hard at the minute!

If he’ll drink coffee we also found that really good to help get things going while she was in hospital and not moving around much, the caffeine stimulates the bowel which can often be ‘lazy’ after anaesthetic. DD drank more iced lattes and espressos than I can count one day as if she didn’t go there was threat of an enema before they’d be able to discharge her..

Thanks all. Your comments are so helpful. Yes he is eating a little soup. He's never had coffee but I can give it a go.

Oh I haven't heard of this. I'll look in to it. Thanks.

When I had an op, we were told to have jelly babies, peppermint tea. Also to make sure walked around, had hot baths, plenty of fluids etc.

Sodium picosulfate is the only thing that worked after my daughters major surgery. It took 10 days for her to go and delayed her leaving hospital.

Sugar free sweeties - the ones with sorbitol in that have a “warning - could cause loose stools if eaten to excess”. Useful as a one-off for occasional constipation where you know the cause is not due to disease or a long term condition. Also more likely to be tolerated than lactulose and similar.

How old is he? My son was on movicol after surgery last month and it kept him going. Having a poo was not pleasant because of the positioning

He's 10. It's horrible, isn't it?

Thanks for all the replies and tips. He's less uncomfortable today (although still hasn't gone to the toilet). We're going to try a short walk soon.

Speak to surgery team / GP asap

They should have provided movicol or something similar as a pre caution.

Movicol works best for our kid. We use the adult version but kids dosage.

Hopefully the little walk will encourage some movement! Its so horrible

Thank you. We had to rush home 10 minutes in to our walk because he was desperate for the toilet. Unfortunately when he tried it was just too painful so he didn't go. Awful!
I called the doctor who said the Lactulose should work and to give it another 24 hours...

It sounds like he needs a 'Saltwater Flush' take it on an empty stomach. 4 cups of water & two spoonfuls of Himalayan Salt. Normal salt won't work.

I'm no expert but please read up on it first it worked for me.

Yes I was going to suggest this too.