13 mth old - screaming and blood when pooing.

[DuchessOfAvon]

I am at my wit's end and wondered if anyone has any advice or experience with which I can prepare myself for the next GP visit.

For four months now, my daighter is having trouble pooing.

She poos every two days and its a large amount of solid poo - but not pellety hard. She SCREAMS. She goes rigid and sweaty and hangs onto me for grim death. Most of the time there is some bleeding usually from fissures around her anus.

She has been on Lactulose (2.5ml twice a day) for three months now and it does not seem to help. For a few days the poo gets very soft and we don't get blood and the screaming is bad but short-lived. Then it'll get more solid again, there's blood and she's very distressed.

The last time I went to the GP they said it is psychosomatic and I need to give reassurance and encouragement but I can not buying that as a theory. She is in very real pain - and the blood shows that.

Do I need to ask about upping the lactulose? Could it be diet? Do I need to push for a referral - in which case, to who?

She's fine in all other respects but this is getting really hard to deal with.

she should not have blood in her poo.The anal fissure is teraing each time she poos. How old is she?
Lactulose may not be strong enough...she may be partially impacted in which case she should get a referral to a Gastro and maybe doc should put her on Movicol or Movicol paediatric sachets. They are much better for getting everthting moving.

Psychologically it will affect her as she will think poo....pain and it will give her a mental block. Will she eat fresh pineapple as this is a fantastic natural laxative or drink freah pineapple juice. Have ainfo on pineapples as it will tell you about their natural purgative effect.
Dont be tempted to use strong laxatives as it will make her bowel lazy ,long term.

Ask about Movicol. DD1 suffered terribly from constipation and lactulose was useless. Once we started her on movicol it really helped.

They do get afraid to poo when it causes so much pain but once you find something that works the fear gradually goes.

My dd is 3.6 now and has been off the medication since the summer.

Best of luck.

BTW what a tosser of a GP

Agree with Alypaly, read the OP and thought get thee to a GP for Movicol.

Can wean back off it once poos are soft and comfy and bottom has healed and the associating pooing with pain will have stopped.

DD1 was on Movicol for the best part of 3 years - it took till she was 5 for the constipation to sort itself out. We were told she had an immature bowel, and we just had to wait for it to sort itself out. She's fine now (nearly 6), has occasional 'tricky poos' but we just increase her raisin/grape intake and things get better.

Psychosomatic or not, she needs treatment to break the cycle of sore poo-withholding-impaction-sore poo

DS2 had this for 3 years and we were refused anything other than lactulose. He is now 4.5 and absolutley fine (just so you know it can be resolved!)

The sweating and screaming is more likely from not wanting to poo when her body HAS to because she knows it will hurt her. She will be clenching so so hard

There are lots of things i could suggest that i did with DS2 but his problems started at birth and we had to go against doctors advice (and got yelled at a lot on here in the process!!). And am not wanting to suggest anything that would cause more issues because obviously i am not a GP!

How old is she?

She's only 13 months, poor mite and its been bad sice August. Its horrible to watch.

I'll ask about Movicol. Thanks for the reassurance that we can get it sorted.

It's awful isn't it?

Do ask about movicol. We reduced (well stopped) DS2's dairy and built it back up again very very slowly.

Is there a different GP you could see? Just for a second opinion?

It is horrible to watch - I'm sure you know about all these but just in case, some things you could try to ease it for her now:

-Vaseline on her anus when she's actually pooing. Can help it slide out

• Fresh orange juice (diluted) to drink

-Will she eat liquorice?

• Try and get her knees higher than her hips when she's pooing. I used to hold DD1 facing towards me, and sort of dangle her bottom over my arm IYSWIM, with my arm at the back of her knees

-Warm bath. OK, she might poo in the bath but baths can be cleaned and it's better than seeing her suffer

oh yes! To echo Poledra..even if you can get her just to sit down to poo that will work wonders but if you can sit her on a potty or on your knee for cuddles it really does help.

We have been creaming her bottom - I must do it more often.
She turns her nose up at orange juice so I am just trying to get as much water down her as I can.
The slung-over-the-arm is definately the thing that helps. As does pooing without a nappy - I often resort to catching it in my hand.

We have also tried the potty but she just goes stiff as a board if you try to sit her on it.
Not tried liquorice .. how would I get that down a BLW baby?!

Baths do help - she often poos an hour or so into the night sleep when she's all warm and relaxed. It causes minimum distress that way but there are still tears and then she has troubles settling back to sleep.

I also wondered about the dairy - it seemed to kick off when she moved off BM onto formula and thence onto cows milk. She isn't a massive fan of cheese or yoghurt but what do I replace the bottles with as she does still drink a lot of milk?

Thanks all for the advice - no-one I know in RL has had any experience of this.

Re the liquorice, I tried this from Lakeland with DD1, and she sometimes ate it, especially if I cut it up into quite small pieces. I don;t know if it really did any good, but it made me feel better to be trying something.

Don't know about the dairy thing - that wasn't the issue for us. One other thing, keep an eye on her urine. DD1 suffered a couple of UTIs which were what resulted in us being referred to a paed, who diagnosed the immature bowel. They thought the hard mass of faecal matter was causing her UTIs, as it could be preventing her bladder from emptying completely. I'm not trying to alarm you, just something to keep an eye out for.

Well, we saw a lovely GP at our new surgery whose own son suffered from this. DD2 obligingly poo'd during the appointment so she saw the full dreadfulness of it all. She pledges to sort it.

We are now on 20ml of lactulose a day plus a bowel stimulent, with instructions to report back in three weeks. I hope this works.

Thanks for coming back to update. Glad you've got a sympathetic GP - fingers crossed it works!