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

We have this problem with DS1 too . I read all about encopresis on Pecka's thread a while ago (the first link on DLeeds post fairly near the beginning describes my DS1 to a tee).

DS1 is 3 in Feb and I have not attempted potty training really at all, but was getting him to poo on the loo / potty as his poos are soooooooooooooooo huge when he does them that they often "break off" in his nappy so some stays inside him and then takes another few days to get out. For some reason he now refuses to sit on the loo or potty and screams if we try to make him, which just upsets him further.

We saw a lovely GP a couple of months ago who recommended prune juice and lots of water before trying anything else. Also bicycling the legs and rubbing the tummy. Difficult to get prune juice into things as he can taste it in everything but he does have a bit in his milk. Tried lactulose about 9 months ago but that seemed to make him get more cramps and not poo any more often. We do have a suppository but I am loathe to use it as I think it will traumatise him as he hates me even wiping his bottom sometimes, let alone shoving
something up!

He is withholding all his poos. He stands with legs together, bottom clenched, gritting his teeth saying "poooooo" while he holds it in. I try to get him to lean forward but it upsets him even more and he gets hysterical if I make him. He often goes 5 days between poos and they are then huge mansize things that must hurt like crazy . He also has the liquid soiling.

The worst thing though is that it really does affect his moods. He doesn't want to play, has no energy and is sad or bad tempered if he needs to poo but cant/wont, has started opting out of activities at nursery when he has not pooed for a few days (has never had a proper poo at nursery since he started last Sept and I think this is poss why it started as he was holding it in). He only goes 2 days a week.

We have a reward chart and he gets a sticker for each poo. When he gets 5 stickers he gets a little toy car to add to his collection. This worked fabulously at first but now doesn't seem to make much difference. He also gets a few Smarties after each poo.

The longer he goes between poos, the less he eats, and often he says he is really hungry, but then sits down to eat and wont touch the food (even when it is food I know he likes). He is eating less and less proper food now, and while he used to eat mashed potato with vegetables mashed in he now wont eat it unless it is plain. He wont touch any fruit. Up to age 18 months he ate a lot of veg and also ate bananas and apples and had no poo issues. He does eat wholemeal bread / pitta bread. Has never liked raisins or other dried fruit. Drinks fresh orange with bits in (but wont drink it if I sneak prune juice in).

I feel so sad for him as gets so upset. Once he has a poo he is a different boy and back to the little lad he used to be (very lively and happy and sociable).

When he first tried it, he would sit on the loo happily, reading his potty book, and being in that position meant the poo would come out more easily. Not sure what to do now?

Sorry, long post all about my own DS1 and no help to the OP . Just wanted to write it all down .

Egg, what a horrible situation for you and ds1.

I would go back to the gp. If he refuses to eat certain food types at the moment, I think it will be quite difficult for you to sort the problam out without medication- at least to begin with.

Some areas have specialist clinics, apparently, I would ask if there is one in your area.

Hope your little chap gets sorted soon.

Poor you Egg - hope things improve soon.

A couple of random thoughts (bear in mind I'm not a doctor, just have read a lot about this subject) - most doctors won't consider treating until 5 or 6, but by the sounds of it your DS has got himself into a bit of a holding cycle already. It is an issue now and needs treating, The problem is, from all I've read the more the bowel 'stretches'from holding all the poo, the less sensitive it gets and the longer it takes to regain control in the long run. So I wouldn't leave it.

Perhaps movicol might be more successful, or possibly (might be completely wrong here to suggest this) giving him the suppostries when he is asleep. I think the priority must be to get the poo out of him, then work on get him regular, then finally toilet training. At three he'll be OK in nappies for a while yet.

Any hoo - couldn't just read this - it is so awful for you and DS. Good luck.

Ah bless you both thank you for your advice. I keep thinking it will just get better, but having read so many other posts on here about older children I do worry that it could still be going on in 6 years time and him smelling a bit pooey and being in nappies at nearly 3 is ok but I fear for his social life as well as his wellbeing if it doesn't get sorted before then.

I think I will go back to docs without him (last time we went he had somehow managed 5 poos in one week and was really happy and leaping around playing games with the doc ) and discuss the options. I hate talking about him when he is there now he is old enough to understand what I am saying but not old enough to have an input into what happens. I keep wondering what would happen if he got an upset stomach, both babies have had a stomach bug a few weeks ago but DS1 carried on with his rocklike man size poos!

Egg

Please read my post on the first page, as we have such similar problems with our children

I would strongly advice going to the GP and then to the hospital (constipation clinic)
And cant recommend Movicol highly enough, although it is tricky to get the dose right, either too hard of too soft..

But each day is different, yesterday dd asked to go for a poo whilst we where in a pub having lunch, whilst today, I can tell she is holding one in again, so I have given her an extra course of movicol tonight and hope she has a poo in the morning.

I think its trial and error
I am hoping to get more advice next week when I go to the hospital.
HTH

Thanks lilymolly I did think you sounded like you had a similar situation to me when I read your first post - except your are pregnant and I am DEFINITELY NEVER EVER HAVING ANY MORE CHILDREN .

I think I will do as I mentioned yesterday and get an appt for next Monday when DS1 and DTs are at nursery so I can go alone to chat to doc and take some info on encopresis as well. He is very sad today as despite having had a poo last night before bed he has been trying all morning.

Hope your hospital appt goes well, what day do you go?

I am the same as you, have to keep reminding myself that DS1 is still just a baby himself. Because he has two younger siblings I forget that he is still so young, and expect too much of him...

Hello, I kept forgetting to check this thread. Poor you Egg, it sounds like a nightmare. I hope he gets sorted soon.
How are you getting on Lilymolly? it sounds good she's asking to go to the loo!
I've got a drs ap't tomorrow so hopefully will be referred to specialist at hospital no probs. I'm really hoping for a prescription of movicol as from what I can gather, that's the magic thing to get things moving! Hope so anyway.
The homeopathy has had no effect whatsoever! Can't say I'm surprised really. I've been pretty diligent re taking the remedies, but nothing at all has changed.

Sorry, forgot to say, thank you DesperateHousewifeToo for the link, am going to have a read now.

movicol is not actually absorbed into the body at all but passes through to the bowel where it attracts water to the bowel and hence softens the stools.

This is a good website.

Hi Thanks Minky

We are actually great

she is having Movicol about 1 sachet a day halfed between morning and evening and that seems to be doing the trick

I cant tell you how happy it is making both dd and I and totally takes the pressure of both of us, and makes us have a happier time.

I swear it makes her appetite better too,as she seems to eat more on the days when she has a massive poo

Hope everyone else is doing ok too

LM

Hello to all . DS1 has had 4 poos in 4 days (usually only 2 per week) but today's one seemed to really make him feel better and he has been very happy.

Lilymolly am really pleased to read that, not only because obviously it's great for you and your DD, but also because I am hoping movicol might work for us if we can get it. I have an appt on Monday to go and see GP without DS1 so I can really chat properly.

Cece that's a great website. I liked the nurse saying she is now known as "The Poo Nurse". I only read one of the case studies (Paul) but it sounds just like DS1.

Can someone who has used Movicol tell me, is it tasteless? DS1 will not take anything that tastes (currently trying to put vitamin drops in his milk/juice/food and he notices it every time and then wont eat or drink that particular thing. Is it something I can easily add to a meal or drink without stopping him eating and drinking?

My dd has moovicol and I mix it with blackcurrant squash. It isn't great tasting tbh.

I hide in a a yogurt drink (you know those drinky type things similar to adult probiotic drinks)mixed with a little water first or add it too smoothie, or chocolate milkshake.

imvho if you try to give it just mixed with water, they can taste it.

DD knows mostly when I give it too her, as I explained it makes her bum and poo better- this seems to work most of the time, but its prob easier to be sneaky about it

So do you reckon he would taste it in milk? He wont drink squash, or milkshake, or anything other than milk, water, apple juice or orange juice.

He tastes everything we try to sneak in (have tried to sneak cough mixture / medised / piriton / calprofen into things in the past, he takes one sip and looks at us knowingly saying "tastes not very nice" and wont touch it.

Gah.

He doesn't care if I tell him it will make his poos stop hurting.

Best to be upfront. We call it the poo medicine. DD is very sensitve to tastes but drinks it as she was in such a terrible state when she was constipated she doesn't want to go back there!

BTW my paed told me not to give DD apple juice. I can tell if she has had a glass around a friends house, have to give her extra movicol for a day or two afterwards... also too much choc is bad too. After Easter we have a bad week always!

OMG - Apple juice is bad??? If only I had known . He likes a little carton of it esp if we are out and I always encouraged it as it was the closest thing he got to fruit. So I will have to just let him have orange juice only?

Thanks for that. Had no idea.

Got some movicol from my lovely GP. Hurray! Only one sachet a day though fopr the prescription. What amount has everyone else had success with? My friends ds has 4. Thinking I may try her with 2 a day as not much point in failing with 1. dunno. hmmmm

I started with 1 a day, then gave one on morning and one on an evening.

That did the trick, then I reduced it back down and the poo went hard again, so I went to about 1 and half a day, and that seems to be wokring for us.

DD is nearly 3, but is very petite for her age- maybe size comes into it?

Not sure about size. Think it might be more to do with size of blockage. DD started on 2 a day at the age of 5 for a month and then went down to 1 per day. At 7 she is now on half a sachet a day as a maintainence dose.

Brilliant, thanks. Sorry for very quick post last night,. was on way out. Also didn't read earlier posts, so sorry you had to repeat yourself Lilymolly, really pleased things are going well with your dd. Hopefully we will be following you soon.

Hello all, minky good luck with the movicol. I keep getting your screen name stuck in my head!

Quick question, do any of your DCs feel sick when they have not pooed, or are ever sick? DS1 keeps saying he feels sick, but is then ok again 10 mins later.

Also on the sick subject, do any of them ever get stomach upsets? DS1 has not had anything other than a rocklike poo for over a year despite the twins having a couple of stomach upsets this year.

Finally, another sick thing... DS1 gets car sick, usually on journeys over 30 mins long, and esp where we go on motorways / fast roads. He is now starting to feel car sick even on short journeys, ie 15 mins last week he said "I need to be sick" half way home, but was fine the minute we go out of the car. Keep wondering if it is related to having half his body filled with poo .

DD very rarely sick or have stomach upsets (touch wood)

One thing I have noticed since she is poo ing regularly is that she eats a lot more and is constantly hungry.

Her tummy also seems to be flatter

Car sickness sounds unrelated if I am being honest, I would try the sickness bands on his arm, or a mild anti sickness tablets?

Hello,
DD used to get car sick, but we moved her seat to the middle of the back seat, and she hasn't been car sick since.
She has a cough atm, and was sick after a big coughing fit yesterday, I did wonder if it was, like you say, because half her body is full of poo, but she's been OK since.
Her resolve is amazing. We started on the movicol twice a day on Friday, and nothing until today, she has done two tiny poos. Should I expect something dramatic?? I've been very excited about it. Maybe the dose isn't enough.

I would stick with 2 sachets a day, it will eventually come, promise

dd alos sometimes had/has little poos, followed by an enormous one.

If she has a massive blockage, it may be worth giving her an extra sachet to see if you can shift it not sure really