poo with-holding, constipation and lots of soiling incidents. I have NO idea how to handle it!

[MinkyBorage]

DD1 is just 3. I started potty training her in March, wee quite successful, but poo nightmare, she go a tummy bug, so back in nappies. Then again in July. Wee great. Dry through night, no wee accidents. Brilliant! Except, poo is always by accident in her knickers. She is obviously with-holding as she will often have several poos (3 or 4) in a day, and atm most of them seem to take her by surprise. She often thinks she is doing a fart, and is surprised by a soiling incident. I eventually realised that she was constipated rather than just awkward, and decided that the best course of action was to put her back in nappies, in order to take the pressure off both of us. I was getting completely hacked off with cleaning up poo out of clothes, and leaving the house was getting harder and harder as you could guarantee that the minute we were out, she would doo a poo. Looking back, I think it probably would have been better to persevere with the knickers, nappies have been a huge step back, and now she rarely does a wee on thje potty or toilet.
I have a sticker chart for her, and she gets a sticker and a treat if she just sits on the toilet for a minute or two, but she won't even do that, she seems to be frightened of a poo coming out. She often complains that they hurt her when they come out, but tbh, I think she is with-holding so effectively, the really hard stuff is still inside her.
I took her to see a homeopath at the weekend, and have decided to give that a go for a month, even though I am very about the effectiveness. I will hopefully then get an ap't with a paediatrician at the hospital who has been recommended as an expert in this field, but I know he will immediately prescribe laxitives, which I am not worried about in itself, but would rather try other things first iykwim.
She's not keen on fruit or veg, although I offer LOADS and dd2 eats loads. She won't drink much water, but does drink juice. Bread, rice and pasta are wholemeal.
I am about to embark on linseed 'tea' to see if that's any use. She won't take any children's fibre supplements.
Sorry, that was very long, and far tmi I expect, but I really feel at the end of my tether.
*Shoul I put her back in knickers now, and start toilet training all over again? or should I wait until the actual constipation problem gets a bit better, i.e. if the homeopath works, or she starts the laxitives
*Should I sod the homeopath and head straight for the laxitives?
*How do I get her to SIT ON THE TOILET???
*This will get better, won't it?

Sorry for very long boring ranty post

My ds went through something similar. We gave him lactulose which really helped. We also kept him on the potty to poo till he'd use the toilet. Don't know why but he was scared to poo on the toilet. He grew out of it eventually.

how long cornsilk? Was it YEARS???

At the time it seemed to go on for ever but now I really can't remember! Was possibly about a year but maybe not that long. We tried not to put any pressure on him really, he did it himself in the end. About same age as your dd.

Have you tried movicol. You dissolve it in a very small drink. It's not a laxative.

It is very common with constipation that there are, oftrn squidgy, bits of poo coming through but like you say the real poo is still there.

I would have thought something like Movicol for a few weeks to get her more comfortable and get over any psycological barrier.

I preferred this to lactulose which I found made my ds go but didn't make him anymore comortable.

there are lots of threads on this issue with older children, it sounds as though she is very constipated if she is still having have liquid poo in her nappies. You may need lactulose to soften the stools & movical to help clear the back log of impactation.

Hi Minky, sorry to hear your little one is constipated. I had the same problem with my ds a couple of years ago and I can totally simpathise with you as it was a really terrible times for him and us. He was terrified to have a poo after a painful incident. The problem got worse and worse and I took him to the doctors lots of times, each time they just increased the dose of lactose. The lactose was not effective for us. In the end I took him to a homeopath and the effects were amazing. I can't remember what treatment he was given but she said it should give him confidence to go to the toilet. After about 3 days, he woke up in the morning and said to us "I'm just going to have a poo" and went to the toilet and did it and never had a problem again. Incredible. The homeopath also told me to stop giving him lactolose as she said it causes stomach cramps (which unbeknown to us was making the problem worse - though I'm sure it does help some people). To this day I don't know what cured him - the homeopath or stopping lactolose, or maybe it was a combination of both??
What was also amazing was the night of the succesful poo, ds said he didn't want to wear a nappy at night anymore and never wore one again!! He never wet the bed and has had only a handful of accidents in the past 2-3 years.

I really hope the homeopath works for you too!! Best of luck with it all!

If you search on my name you will find an extensive thread about my daughter, who now 9 has suffered this problem since she was your daughters age.

Have a read of it and see your GP and hopefully get it sorted now instead of it dragging on for years

Its horrible, you have my sympathies xxx

I would ditch any idea of toilet training for the moment as until she can teel that she needs to go to the loo herself i.e. feel the need, she will always fail.

Instead, definitely concentrate on dealing with the constipation. As it has been going on for a while I would visit the gp or, even better, the specialist, if you have access to one (I have no experience of a homeopath for this).

I would think that the dietary and impaction issues need to be dealt with first.

She will probably require some sort of medication/laxative to sort out the impaction quickley and longer term, looking at her diet and trying to get her to drink more and eat more high fibre foods.

I understand that some foods can not really do their job in terms of bulking out (and so, softening) the poo unless there is adequate liquid present in the bowel. So they themselves can cause more constipation (think of how sticky pasta can be without lots of water).

Hopefully, any impaction can be treated fairly quickley but the long term maintenance will take longer (months).

(My ds had these problems from about 4yrs. He was treated with lactulose which dealt with the impaction and got his bowel moving regularly in about 3-4 weeks. We still have to make sure he drinks enough water each day and encourage plenty of fruit and veg otherwise he gets the odd skid (TMI!). But evrything is soo much better now - 3yrs on)

I had similar problems with ds. We took him to the GP and he was prescribed lactulose and senna for his constipation. This very quickly stopped him being constipated. However, we did have accidents for a few months afterwards - the GP said this is to be expected, because the bowel has stretched and lost some tone due to the long-term constipation/impaction. It takes a few months for the bowel to regain its tone.

Ds is now nearly 8, and still on the laxatives, but he has no problems with accidents. The GP said there are unlikely to be any problems with being on the laxatives long-term, and it is much better to have them than to carry on being constipated. Ds has a very healthy diet btw, including lots of fruit and veg, but still was constipated!

leave her in nappies for time being.

The pressure from the full bowel can cause her not only soiling accidents, but can also cause her to have problems tellling when she needs a wee.

I would put back in nappies until you get the constipation sorted as it can make more behavioural problems, when they are having problems controlling it.

We did it with ds, was told to not toilet train until sorted by the paed. He trained later but got ht ehang of it quickly.

*behavioural problems was the right phrase - more along the lines of it gives them issues, which it turn make witholding poo (so leadin to more constipation) and problems with toilet trainng more likely.

GAH
behavioural problems was NOT* the right phrase.

I do not know what is wrong with me today.

Thank you for really brilliant advice, and also, it's good to know we're not alone. Great, I'll leave her in nappies for the time being, that makes much more sense. Can't see the wood for the trees sometimes!
Phew, that's a strange one in itself. She's so bright, and I feel defensive about her being the only one of her contemporaries who is still in nappies. I do know how ridiculous that sounds!
I think I'll see GP next week to get a referal to the paediatrician at the hospital, by which time, we should have a better idea if the homeopathy is doing anything useful, like youtr story giddyaboutj.

Movacol is what I was hoping they'd prescribe at the hospital, but I thought it was a laxative though??? although I know it works differently to lactulose. Can you buy it over the counter?

Peckarolloveragain, I can't find any threads about your daughter, has your name changed slightly? I'll try again anyway, perhaps I was doing something wrong.

I have this great book, but it doesn't actually tell me what to do, or give me an action plan, and at the moment, that's really what I need. I can't tell you how helpful it is hearing from you all.

Has anyone found this quite an isolating condition? It took me ages to realise she was constipated, even though I have been to the doctors about this, and they didn't realise. A lot of the people I talk to about it seem to think that because she's pooing, then she can't be constipated. My Mum is really annoying me. She clearly thinks that if I got her to sit on the toilet at the same time each day, then she would do a poo, and the problem would be solved. I don't really care what she thinks, but it is annoying, and she's really anti the idea of the laxitives because she doesn't believe dd is constipated in the first place! Grrr!

movicol is strong stuff and as a result prescription only. Gps are reluctant to prescribe it and would usually pass you over to a paed.

Different laxatives do the job in diff ways.
Lactulose softens the poo I think, while movicol (I think) forces the body to poo.

Took us over 18 months to get the gps to do anything about ds constipation, by which point we were desperate. He was in a lot of pain and was vomiting wiht it by the time we managed to see a locum who couldn't believe he hadn't been referred to the hospital before.

I am still about it as a) he spent a long long time in pain and b) it has fucked up his eating which is taking a long time to sort out.

Minky, I tried to find pecka's thread (I remember it well). I think there is something up with the search facility as it is not showing anything from before about September.

Will try another time.

According to Tech, search facility should be back working properly by sometime tomorrow

Hi

You could be me at the moment

Very similar to your dd.
Mine is 3 in Jan and has no probs with wees since April
But has always had poo issues, and the leaking that you describe which is called encopresis btw.
After a lot of shouting and upset in our house I took her to doctors
We tried lacutlose, and senna, but nothing really worked, eventually begged for Movicol and gave her about 2 sachets a day which seemed to make her have a leak- when this happened, I put her on the potty and really encouraged her to push her poo out and made her blow a balloon as this makes the msucles in her anal spincher squeeze the poo out- This happend a few times and every time she did a poo on the potty we gave her sticker and made a fuss and she was delighted
Must say wees have never been a problem but doctor did say this was remarkable, as the constiaption would usually make children lose control of their bladders too.
Anyway que a week later and I reduced the dose of movicol and last week dd sat on toilet to have a poo and it really hurt her as it was hard.
She then held in in for a few days and the leaking started again put her back into pullups
Put her back on movicol twice a day and really made her (by gentle persuasion)sit on potty and poo this worked and this is now where we are today.
I got an apt at a constipation clinic for 6th Dec this week so waiting list is not bad at all (Durham area)

I have NEVER been sooooooo stressed in all my life over this issue it is soul destroying and incredibly hard to deal with and no other kids her age seem to have this problem which is difficult to deal with too.
ANyway I am not sending her to nursery school until Sept 09 and I am having another dc in March, so I am taking the pressure of myself iyswim?

I do lose it completly with her sometimes thought as she is such a clever little girl and I give her more credit than she deserves as she is not even 3 yet---still a baby really

Anyway hope that gives you some support

If I where you, I would put her back in nappies (pull ups) get her pooing regularly, and try to realx, once her poos are sorted, and she has more control of her wees then try the potty training again.

Best of luck

If you want to e mail me please ask and I will send email address
LM x

movicol makes the peristalsis (sp?) happen which moves the poo along the gut IYSWIM

Thanks DesperateHousewifeToo, I'll have another look tomorrow.
LilyMolly, thank you for your post, It's really interesting to hear your story. I too got really upset with DD, ended up losing my temper with her, I feel awful about it now. It really is a stress.
DD started nursery a couple of afternoons a week in Sept' and they've been great about it, although I think they were quite pleased when I put her back in pull-ups! I'm pg with dc3, due March 26th! what's your due date? I'm feeling pressure to get this sorted before then as I can't imagine I'll be able to devote a fraction of the time to it come March!
I'm thinking I might forget the homeopath now. Hmmm. Can't wait to see the paed, it will be such a relief to actually have her doing normal poos!

My DD was dry at 2yrs 3months but then got really constipated and eventually would only poo in a nappy until she was just over 4 I think. When she was at morning nursery she never had an accident - just used to hold it in til she came homw. Was on lactulose for most of that time. Dr kept telling me to give her time, it would happen - and it did ! but so stressful as you say. Letting her poo in a nappy took away some of the stress/confrontation and helped the constipation which was a bigger issue. It will sort itself out, try not to get too stressed or it will take over your life.

Hi Minky
I am due 17th March! but as dd was 14 days late we are aiming for 1st April

I totally lost it with dd on Friday and we both ended up in tears

I think the poo issue compounds every other thing that I deal with.

But today she had another poo on the toilet, but she still needs persuasion and bribary (todays was a lolly!)

Keep smiling and dont let the pregnancy hormones effect you too much.

I have felt so ill with this one, and have so far avoided alcohol but tonight I had a nice small glass of Rose wine.......Bliss x

Good information here
Treatment works well but needs to be consistent and long term. If laxatives given on a stop and start basis child keeps going back to square one when they get a painful poo.
Chronic constipation fairly common in 3 year olds, usually starts off with a painful poo then child decides not to go any more because it hurts and resists urge. Poo backs up, bowel stretches and loses elasticity. Long term laxatives needed to ensure regular pain-free clear outs and restore bowel tone. Not all GPs understand about need for long term laxatives, you could check yours out and ask for paed referral if doesn't seem clued up.

We had the same problem with ds. He had lactolose from GP and then like you we went down the homeopathic route. I have to say it has worked brilliantly and even now (he is 6) we have to give him a remedy once in a while. It is definitely "stress" (lol for a six year old) related.

Be warned though the lactolose is really full of sugar and my ds has had two fillings as a result of having it. Make sure you clean teeth after it.

Also I have to limit my ds to a banana occasionally as they seem to bind him up. Also too much fibre in the diet can be as bad as too little IMO.

Have to go out but will log on later to share some more info.....

my ds was like this 16 years ago (he won't thank me if you tell him you know - RL friends please pretend you haven't read this).

1. it does pass. he is now nearly 19 and never cacks himself to my knowledge
2. you need to work out whether it's physical or psychological. There is a link of course - if they have a painful poo it puts them off, if they withhold the poo hardens and becomes painful.
3. if it's psychological - and avoiding the loo, sometimes being able to go without noticing or straining does indicate a psychological aspect - then the thing we did THAT WORKED was to stop stressing and ignore it. I put him in pants for daytime, occasionally casually asked him if he wanted to do a poo, if he pooed himself then just changed his clothes and mopped him up without comment. YES it was messy for a while and the re were multiple accidents but then suddenly it started working - he did some poos on the loo, got good pats on the back for doing so BUT NOT OTT, and got on with his life

He did suffer for a few years if he got stressed - not big accidents but wet farts (urgh) - but again relaxed and accepting was the way to go.

SO the usual advice for toddlers - ignore the bad behaviour, reward the good behaviour, chill, and it will most definitely all be over by (next) Christmas

here is the link to Pecka's thread.