Chronic Constipation/with holding / Medication - what to do next!

[MegM14]

Hello,

Any advice is appreciated..
My 3 year old daughter suffers chronic constipation due to withholding. This has been ongoing for well over a year/2 years. She is (or was!) fully potty trained however due to the constipation she is now back in nappies. The Consultant at hospital has prescribed sodium picusulphate once a night and 2 sachets twice a day of movicol. This means she is just leaking stool a lot and can't be in pants. It is like she has absolutly no. control over her bowel. She hasn't done a solid poo since last year. when she was doing solid poos it was anything from 7 - 15 days apart, extremely sore and has caused her to develop a fear of the toilet now. Her diet is ok, it could be better but she is fussy 3 year old. I push the water and fruit and veg. I try keep her active etc. We have tried everything to get her back on the toilet to try poo.. bribery, being firm, books, videos you name it. Nothing is working. I feel she is totally reliant on medication for her bowel to even move now. I can't see any way out of this and can't see her being out of nappies again as we can't get the constipation under control. the medication gives her diarrhoea... no medication is constipation and Hell!! It's a catch 22!! what can I do?! I am at my wits end. I just want her to be able to poop normally and not be in pain and not be scared!!

thank you!

Check out the ERIC website. They have amazing resources about what to do for chronic constipation and how to help them recover from it. You can also speak to them for advice too.

They're better informed so that you know what to ask a GP for if necessary.

https://eric.org.uk/

That sounds like a lot of movicol, no wonder she has no control.
My little one aged 2 was having 1 sachet each morning which was enough to keep things moving.
I’d have a go at slowly slowly reducing the amount she has, cut down by half a sachet every 3 days and see what happens.
Also, look at possible intolerances which could be causing the constipation.
Once I stopped cows milk in my son things drastically improved.

Good luck!

Is it 2 sachets twice a day eg 4 or is it two sachets per day that you're giving separately? Has she been given an x-ray to check for impaction? What is the dose of the sodium Pico sulphate she's taking? My son has been on movicol for 18 months, Pico for about 10 months - he has coeliacs disease and autism (so diet atrocious).

I second the ERIC website. Found them way more useful than the GP.
for my daughter, she has suffered with constipation for years and a few months ago was soiling her pants - it was quite loose. Turns out she was impacted, so we did a disimpaction regime and gave high dose movicol (6/7 per day) for a ‘clear out’ and things have improved since then. Not sure if this could be the same thing or not

Hello! Thanks for reply. It’s 2 sachets, twice a day. So 4 sachets overall.

shes been impacted a couple times (trips to Gmeds/ a and e) where they’ve felt her tummy and said she’s impacted but never x rayed. She’s had the disimpaction movicol regime a few times now. It sorted her out very short term.

its 5 mls once a night for the sodium and this is starting dose. We’ve got a review at the end of the month.

we went away for a long weekend and I didnt give her any meds as I stupidly forgot. And she got constipated again immediately. She stopped leaking poo but she got constipated and passed a massive hard stool. I mean massive!! 😩
so I’ve re introduced the meds and she’s in between just now.. she really needs a solid poo (im catching her holding it in and is leaking a bit again! )

i queried allergies with the consultant at hospital but she said that it would show more as loose stool rather than constipation! 🤷‍♀️

Sorry I missed the replies. Thank you all for replying

allergies - gp initially thought this but consultant at hospital appt said it would show up as more the other way, diahorrea rather than constipation

she has bad eczema and constantly scratching / itchy so I did also think some sort of allergy or intolerance.

weve been looking at the Eric website since this all started. It is very helpful but I feel we’ve tried everything from it now 🫠

Allergies can most defiantly cause constipation ! Have a look into non IgE Cows milk protein allergy especially with her having eczema too , you might need to eliminate dairy from her diet

My son was diagnosed with chronic idopathic constipation and a cows milk protein allergy from 2 weeks old x

We had a few years of this with my daughter, she was so bad it was affecting her bladder, to the point she was admitted to hospital and they were about to put a catheter in as her constipation was so impacted she couldn't/wouldn't pass urine either.
Unfortunately an anesthetist wasn't available and after several nurses trying to pin her down to keep her still enough to insert the catheter without doing any damage a nurse found some gel that numbed the area and although it was still too risky to put the catheter in, she finally managed to go to the toilet.
It was such a long time ago I can't remember what the gel was called but they did let me have some for emergencies.
It was a struggle to get her to take movicol and it didn't seem to help from what I remember.
For occasional use I found glycerin suppositories for children helped.

OP, have you tried eliminating dairy? I experienced this with my son, so similar to your experience. When my DD was born and he was 3.5, he decided he longer wanted milk as that was for babies, and miraculously, his constipation was gone almost overnight. For him, it seems to be an intolerance rather than allergy. We keep dairy to a minimum. Even if he has more than one yogurt a day, he seems to bung up.

The same then happened to DD as she came off formula and on to cows milk. Her constipation was horrendous. We quickly switched her to oat milk and again, constipation stopped.

I wished we’d eliminated it earlier for DS as it was 2.5 years of struggle with Movicol, suppositories etc. Awful. Once his stools softened, he was happy on the toilet.