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Original poster

Constipation- lactulose not doing anything

43 replies

orande · 01/10/2023 15:41

What's the next thing?

My 26m old had had constipation for months. Literally months and months.

Doctor prescribed lactulose and she has it everyday!

She goes for a poo every two days- she screams and screams. I have to 'help' her with it.

To the eye- it doesn't look hard. It is just HUGE.

She bleeds after too- always blood on the toilet tissue. So, I assume she has a fissure that is re opening?

Her diet is varied and drinks a lot too.

What else can a doctor do? Because senna etc isn't needed as she can 'go' it's just it hurts her!!

It's horrid watching her scream and cry.

Any advice would be great. Thank you.

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AThickLayerOfLard · 01/10/2023 16:10

Lactulose is rubbish ime.
Have you tried prunes and dates? Whole Kiwi fruit (so including the skin) are also very good for constipation but do need to be eaten daily. May need to be chopped up to be appealing though!
They can also prescribe movicol but that’s a bit too effective sometimes and can cause diarrhoea. It may be useful to get her into a routine though.

redavocado · 01/10/2023 16:12

I'd go back and ask for a paeds referral. We finally got one after a year of soiling and movicol which did nothing (DD is now 5) and it finally feels like we're on the way to finding a solution. The GP was pretty useless.

I really feel for you though. It's so hard to know what's actually going on and how to help them!

DustyLee123 · 01/10/2023 16:13

Prunes, prunes, and more prunes. Plenty to drink, and plenty of fruit & veg.
If you do that and it doesn’t improve, get a referral.

LittleBeaS · 01/10/2023 16:17

My little girl is 2.5 now. She has suffered since she was 4 months and sounds very similar to your little one. The dr couldn’t do much except Lactulose but they eventually wanted her seen by a consultant after I showed the videos of her screaming when she went (with us ‘helping’ her as you said). The consultant prescribed Laxido when she was 10 months and she has been on it ever since, along with daily fresh orange juice and prunes. We’ve tried weaning her off it and end up back at square one. I’m certain things still aren’t ’right’ but so much better for her than before - she isn’t in any pain anymore.

lndnbrdge91 · 01/10/2023 17:01

Kiwi fruits as recommended already are excellent as they contain both soluble and non soluble fibre. Defo worth a try if you can get your dd to eat them.

Stillamum3 · 01/10/2023 17:08

Chopped up dried apricots might help. Hope you can find something that works soon!

Potatomashed · 01/10/2023 17:12

OP have a look at the ERIC guidelines and get some support for child bowl health, it’s really important! Sounds like you’re doing a lot but could do with more professional support

Outnumberedbywillies · 01/10/2023 17:12

My 2 year old is like this, he needs to have 2 sachets of laxido every day to make sure he goes regularly and doesn't become bunged up. Lactulose is rubbish as it's only a stool softener. Prunes chopped up in custard are also great if she'll eat that.

Original poster
orande · 01/10/2023 19:04

We already do the kiwi and prunes. And apricots! drinks plenty too.

We have got some cosmogel to too... which I think is like laxido? But I just can't get her to drink it!!

OP posts:
Hungrycaterpillarsmummy · 01/10/2023 19:07

Lactulose and picosulphate in a tiny tiny dose which you will need prescribed.

Our son witholds after a bad bout of constipation. Picosulphate literally makes him go . It's only sold on adult version which is why you need a prescription (or you go to boots and say it's for you to buy it over the counter) I'd start with 1.5ml

The other thing is ensure she is drinking plenty. Watermelon is good for that as are ice poles

MellyMavis · 01/10/2023 21:01

Movicol/Cosmocol etc is what is recommended. I have some success mixing it up and then syringing it into my daughter. Don't feel you have it give it all in one go...

My daughter has chronic constipation to the point we are now seeing a surgeon.

MellyMavis · 01/10/2023 21:04

Yes, also backing up the comment about the incontinence/bowel team- I think you can self refer.

endofthelinefinally · 01/10/2023 21:10

orande · 01/10/2023 19:04

We already do the kiwi and prunes. And apricots! drinks plenty too.

We have got some cosmogel to too... which I think is like laxido? But I just can't get her to drink it!!

I think that is too much roughage for a small child. I would give stewed apple, vegetable soup, prune juice. Lots of fluids - fluid can be soup, jelly, ice lollies as well as drinks. If you are giving dried apricots they are not recommended for small children because the swell so much they have been known to cause obstruction.

OdeToBarney · 01/10/2023 22:00

You need paediatric movicol or laxido. Start with half a sachet and dose up as needed. Lactulose was useless for my DD. I would also consider taking dairy out of their diet for a few weeks to see if this improves the situation as constipation can be an indicator of CMPA. But try one or the other so you know which is most effective. My dd never appeared constipated,she was just full of poo.

Oaktree1233 · 01/10/2023 22:07

Phsio might have some exercises to do eg child is on back on floor with raised legs. You push against their feet with your hand towards their stomach.

Otherwise Moviocol worked for us but you need to titrate up and lots lots of water…within reason.

Original poster
orande · 02/10/2023 12:18

OdeToBarney · 01/10/2023 22:00

You need paediatric movicol or laxido. Start with half a sachet and dose up as needed. Lactulose was useless for my DD. I would also consider taking dairy out of their diet for a few weeks to see if this improves the situation as constipation can be an indicator of CMPA. But try one or the other so you know which is most effective. My dd never appeared constipated,she was just full of poo.

I did think about this regarding dairy because I had the same issue with me son; 11 years ago now!

But I breastfeed so I thought that she's of had problems a long time ago now?

OP posts:
Potatomashed · 03/10/2023 18:10

My LO happily drinks plain laxido mixed into Ribena squash in a special cup with a swirly straw for the pp who couldn’t get it down their kid. She won’t touch movicol!

Wishiwasatailor · 03/10/2023 18:14

You can add movicol to most things except milk BUT IT MUST BE MIXED WITH PLAIN WATER 1st for it to bind with the molecules and for it to work effectively

Original poster
orande · 03/10/2023 21:22

Today is day two on cosmogel (macrogol)! So that's a success. I put it in with squash and she hasn't made any complaints.

Still no bowel movement though since the day before yesterday. She wanted to go tonight but cried on the toilet and didn't in the end so I am expecting it'll be tomorrow.

Will the cosmogel make it softer for her?

OP posts:
Original poster
orande · 03/10/2023 21:22

Wishiwasatailor · 03/10/2023 18:14

You can add movicol to most things except milk BUT IT MUST BE MIXED WITH PLAIN WATER 1st for it to bind with the molecules and for it to work effectively

Yes I mix her cosmogel with 62ml water first. Then make up squash and add it in.

OP posts:
Wishiwasatailor · 04/10/2023 06:59

How many sachets is she having? She may need several a day until it is soft enough to pass easily. It doesn’t sound as if she needs disimpacting if she is passing large hard poos but keep on eye. Look up ERIC and contact them for advice if it’s not working they are much more knowledgeable than most GOs on the matter

Original poster
orande · 04/10/2023 12:39

Wishiwasatailor · 04/10/2023 06:59

How many sachets is she having? She may need several a day until it is soft enough to pass easily. It doesn’t sound as if she needs disimpacting if she is passing large hard poos but keep on eye. Look up ERIC and contact them for advice if it’s not working they are much more knowledgeable than most GOs on the matter

I have emailed them! Waiting for a reply.

She's only having one sachet a day. She really needs to go but is definitely holding it in as I am assuming she's scared to go :( lots of farting and crying that she needs to go but won't go when I sit her on the toilet.

She seems to go every two days so today is the day I think. And yes, they are just huge and solid. So sad!

OP posts:
TheCurtainQueen · 04/10/2023 12:57

You need to see a paediatric gastroenterologist. You can’t let this carry on for months, your poor child is in pain. Of her bowel is constantly being stretched it will be doing long term damage.

Wishiwasatailor · 04/10/2023 13:44

probably worth increasing until it’s easy to pass. You don’t want her to start withholding because of the pain

headcheffer · 04/10/2023 13:59

After two years of struggles the thing that has cured my DC of this is some probiotic gummies from Amazon. These ones!! Kids Probiotic Gummies – Probiotics for Children – Kids Kind Tummy Gummies – Vegetarian - 1 Month Supply – Vitamin D & Calcium – 30 Chewable Kids Vitamins – Childrens Gut Health - by Novomins amzn.eu/d/8Uhz0Tb