Thirteen-year-old with chronic constipation, hospital advice feels very limited

[Allthedays1]

My son has had chronic constipation since potty training. He's now 13. He's under the hospital but we just go and they weight him , feel his stomach and say keep taking the movicol and Pico and that its common
He now hasn't pooed in 3 weeks properly. He's had loads of meds and even supositries which he has been prescribed just in case.
All the hospital have ever done is a blood test to check for allergies. Is this just our life forever? He's started lying about taking the meds cos he hates it
Last time I went to the doctor they said get him to wipe his bum with a baby wipe because it works for puppies...
He doesn't eat that well or drink loads and he's recently been diagnosed with ADHD and autism
Can anyone help? I've just called 111 and in the call back they were really snotty and said that even a bit of seepage counts as poo ( I put on the form he hadn't pooed in 5 days)
They said if I want I can get an appointment for him so they will call back in 6 hours
My 7 year old daughter also wiyholds but to a lesser extent and I mentioned this and they said maybe they just have a slow bowel.

I dont know. I had chronic constipation as a child and don't as an adult. It was a very emotion based thing for me. 1 of my DC is the same and has been since weaning really. It is hard seeing them so uncomfortable

How did you fix it? It does get worse if we go away, but he also seems to ignore it if he's on a console. I just find it odd they've never scanned him or anything. It's just the same old thing but it's no better

This sounds really tough. Obviously it’s a long term problem which makes solutions harder! Bowel will be saggy and slow 😢

Im assuming you know about the movicol dissempaction regime and have tried that?

have you been on the Eric website?

If he hasn’t had a coeliac test get him
ome

Try adding flaxseed to food. It usually makes a huge difference.

EDS causes poor gut motility......has this been ruled out?

I second this . My granddaughter had chronic constipation from babyhood and diagnosed with Coeliac aged 4 .

This sounds terrible OP.

Has he ever followed a proper impaction regime to actually clear everything out and start learning to feel when he needs to go? Has he seen a paediatric gastric/bowel specialist nurse? Has he ever had a colonoscopy?

Not saying he has this, but I recall seeing a medical documentary where a child had similar, chronic constipation. It turned out that the lower part of their bowel didn't have peristalsis, so didn't move the stool along as it normally should. I'd be pushing for more testing and as others have said, for coeliacs and EDS amongst other things.

Agree with coeliac test.

You could get gut bacteria tested, or just make an effort to improve his. How varied is his diet? Is there plenty of both soluble and insoluble fibre?

My ds was told to try MCT oil (I think, the active ingredient in coconut oil). 1teaspoon and on the toilet an hour later. I tried it and same effect.

Have you spoken to a pharmacist? I find they tend to be more I terested and will give you repeated advice as you try and fail.

Try try try to not let him ignore any urge, even if he is far into a gaming campaign (and yes I know he's a 13 year old boy but do your best!). Every time we don't go when our body 'suggests' it more moisture will be sucked out of the poo making it harder and drier and less likely to come out easily. Also he needs to be drinking lots and lots of water, if he's not a big drinker give him ice lollies, watermelon, pop, anything liquid. I had a withholder. He is now an adult and parent himself and I'm presuming over it but not a conversation we have had lately!

the other random thing I tried after all the liquids in various forms, prunes made into more attractive foods, also ground flax and if it was nowadays I'd be trying to get soaked chia hidden in stuff (anything mucilaginous) to ease everything through. Possibly also okra.

Yes been on Eric loads and also did the dismpaction multiple times. I'm not sure what to to next

How do they test for coeliac? I imagine the blood test was for allergies? He used to be allergic to milk protein.

I was just about to post this. There is also a well documented link between EDS, Autism/ADHD, abd poor gut health and motility. Worth exploring.

Has he ever had a biopsy for Hirsprungs disease? It’s rare to diagnose it late, but it can happen. How soon after birth was his first poo?

He's under the pediatrician but that's it! I've asked before why don't they do an x-ray or anything and she said that doesn't work with constipation. They have literally done nothing but a blood test twice and prescribed movicol etc. This year when I went I said but I'm really worried about him because he's really little and he's not growing and she just said constipation is really common and he is growing because he's following a curve.. it's so frustrating

I've also we have done impactions multiple times but not lately because they don't work he never gets to gravy and it's impossible to get him to drink 12 sachets a day when he's at school.

OP there is a lot to be said for medical
intervention but if your son has chronic constipation and you said his diet isn’t great this won’t help.

Prune juice, kids of water, loads more fibre etc will help in the meantime. You haven’t said anything about this so think you should consider these things.

Unfortunately movicol and picolax need fluids to work. They also won't work on any hardened stool in the rectum. Have you tried glycerine suppositories? It's so distressing and uncomfortable to be constipated.

Last summer holidays he was having 12 sachets a day for most of the summer holiday and he was still constipated at the end of it

He had used them this time but no effect
. However he also may have not put them in far enough but he's 13... I can't do it for him. Would tramatise him

I assume that since he isn't drinking much liquid then taking Movicol or Laxido (or psyllium husks) isn't going to be an option. But if you can get him to drink, say a smoothie made with psyllium, it might help. But don't give him psyllium or chia without liquids or it can make him even more constipated.

To add, does he use a squatty potty or anything to raise his feet up when sitting on the loo? It can make a massive difference to the ease of passing stool. You can buy discreet, fold up types to hide away for when he doesn't need it.