Constipated 3 year old - desperate for help

[pollypocketss]

My DS has suffered with constipation since he was 1.

The doctors have given cosmocol to mix into his drinks but it doesn't really work.

My son struggles to pass his poop and when he does it's not in pieces (tmi sorry) it looks like a big rock but is the texture of clay (tmi again sorry).

At home I try and keep up his water intake, given him probiotic drinks, and mix sugar into any milk he may drink but usually once every few weeks we are back to square one.

He really struggles and it has made potty training take forever. He is potty trained now and does poop on the toilet but when he is heavily constipated or dealing with impacted stool then he will cry with the discomfort.

GP just says he will grow out of it and to use cosmocol more regularly but he doesn't always need it and I can't figure out what causes this random constipation, usually red meat or ghee but not 100% sure/

He has been trying to pass for the past two days and I don't know what I can do to help him. Please help..

Most children in this situation are better off staying on osmotic laxatives (movicol etc.) for a long time establishing 1-2 soft stools per day, rather than trying to wean them off but then having to reintroduce. If there are big impacted stools a "clear out" with higher laxatives doses may be needed first. The goal is to get the bowel used to stretching out the right amount and not too much, it needs a long time to "learn". ERIC website is probably the best starting point if you haven't been there already.

If he drinks milk, is it full fat? If so, I’d switch to semi-skimmed - that solved my 3 year old’s issues overnight.

Go to the ERIC website for advice.

You need to be referred to continence team asap for much better advice. Your ds will probably need to undergo a disimpaction regime using movicol or laxido. Look into the Eric website and the face book group movicol mummies, both of which are really helpful

pp who says about children needing to be on movicol for a long time is correct. My DC has been on it daily for 5 years

You need to not keep stopping and starting the cosmocol - as pp says they have to take it daily for a long period of time to establish a daily poo routine.

I've had 2 DC with constipation issues and I'm not sure what the adding sugar to milk is about? Not heard that before.

Yes he does, I will try that.

Thank you.

I stopped it because his pops inbetween are normal and soft, when on cosmocol daily he ends up with very loose/watery stool.

Should I continue with a daily low dose?

Has he been tested for hisrchsprung's syndrome? It's usually diagnosed at birth, but in milder cases it's not diagnosed til toddlerhood. I was diagnosed at about age 3 and it took my mum a lot of back and forth to be taken seriously. I needed 3 surgeries to sort it but have lived normally ever since.
Please ask specifically if this could be an issue and for a referral for a test.

Thank you for the website suggestions and all the advice will take all on board going forward.

What shall I do about him struggling now? He's not eating or drinking much as he's focussing on passing this stool but he has been for two days. Small pieces have passed but usually it eventually passes as a whole but this time it's taking days...

Prune juice works wonders. It will take a day or two to take affect, as the already formed hard stool needs to pass first.
Does not taste great, so I mix it with sparkling water for dc. Half a glass in the morning and half in the evening.

As other have said, if you haven’t already, look at the ERIC website and listen to their podcasts etc. If you use Facebook join the Movicol mummies group. Give 1 sachet of cosmocol every day for a minimum of 6 months. If his stools become too loose reduce to half a sachet a day. Stopping and starting causes problems. When you reduce to when him off do it very slowly, don’t suddenly stop.

Ask the GP or pharmacist for glycerin suppositories to help him right now.

https://www.chemist-4-u.com/glycerin-children-2g-for-constipation-12-suppositories?gbraid=0AAAAADMV1WQi7ijCApaO4R0fsFHrkMlhL&gclid=Cj0KCQjwm5e5BhCWARIsANwm06ipdQmAymINkhiUCKVCL6zpgV0kVSnxf_ZOv1bjVhMgZPySJj4FlRMaAvZrEALw_wcB

If you ring 111 now they will probably send a script to a chemist for you today.

The child needs to try and hold it in for a minimum of 20 mins 30-40 is better. It takes time for the suppository to melt and therefore work. They are best lying down on their side with knees bent watching tv to distract them while it works.

Thank you, I'm heading to a pharmacy now.

Thank you all so much, wish I asked months sooner! I could cry.

Prune sachets, pears and apple juice are great helps. Dates if they'll eat them. Mix flaxseed into porridge or into weetabix, or hide in food. Teaspoon of milk of magnesia each day. Switch to wholemeal bread rather than white. Increase veg intake. Stay off stodgy white stuff.

Out of interest, what's the benefit of adding sugar to milk?

Yes you want a (probably) lower dose daily so you aren't getting either watery or hard stool, but somewhere in the middle.

There is a really useful video on youtube called something like 'the poo nurses' where they explain how to use the macrogol sachets to best effect.

My daughter suffers with constipation and got heavily impacted. We ended up under the continence team and having scans to check the progress. She had to take 15ml of lactolose every day for 3 months to fully clear the impactation. It did take nearly 3 months to clear as well. Some days the stool was watery or soft and appeared "normal" but then a few days later we were back to hard lumps that were difficult to pass. We were told to keep taking the high dose every day until the scans showed clear. If that had not cleared it then we would have got movicol and to do it again. She is now on a maintenance dose of 8ml every day and has been for the last 5 months. So far so good. We were told to not stop the lactolose for at least another year even if we think she doesn't need it.

For acute constipation, we‘ve found eating dates gets everything moving.

DS‘ constipation cleared up when we drastically reduced his milk intake. FWIW.

Agree with all pp re ERIC & regular movicol.use.
Just to add though have you mentioned to GP/HV about the clay like stools? This can be a sign of digestive issues

For myself the best has been prunes. No matter how long the constipation is, after eating prunes, the effect is almost immediately.

Constipation in children is very poorly treated by many UK GP’s. You should’ve been given much better advice before now. The Facebook group are really helpful and you’ll always get a quick answer. Keep posting here or there for help and you can ring ERIC as well although it can be hard to get through at times.

Hi all me again.

Pharmacies did not have the glycerin treatment for kids.

My son is still pushing and think he is shattered. I have given him a dose of lactulose over last night and this afternoon, I can hear some gas releasing and little parts of stool are breaking away but he is very still suffering from impacted poop.

Applying lots of cream as he is very sore around the anus area.

He isn't eating much but drinking plenty's adding prune juice to his water and also using clafig.

Tummy massages, warm bath to help him relax. He plays and is himself but just walking while tensing and pushing inbetween.

Changed any milk he drinks to semi skimmed.

Not sure what else I can do other than wait for the lactulose to kick in?

Kept a packet of soft dried apricots in the fridge and give him a couple to eat every day. This is what gp recommended to me and they do work