Bloke needs help re toddler constipation

[MumBloke]

First up, I am a Dad. Before you throw things at me for invading Mumsnet I come genuinely looking for advice. I'm not aware of an alternative Dadsnet forum and I'm not entirely sure they'd be much help anyway .

I have a 3 (near 4 year old) toddler who is perfect in almost every way other than she is a difficult eater and subsequently (at least we assume it is linked) has currently got issues with constipation.

We've tried all the obvious methods (prune juice, aloe vera juice etc) and simply "try giving your daughter some fruit and veg" isn't really an option. We can't actually force feed her. We've gone down the route of incentive charts and basically none of it appears to work.

The current situation is that she is severely constipated which has led to incontinence. She is toilet trained for wees but basically has lost all confidence with her number twos.... because of the severe state of her constipation she is more or less soiling a little bit all the time. Having read about it on the net it appears that she is severely constipated and therefore that she is, to all intents, "leaking". Sorry for the detail!

Our GP has initially gone down the softly softly approach of prescribing senna, starting with 0.25ml, then 0.50ml and finally 0.75ml. None of this has worked in that we have endured a nightmare situation of constant soiling. All of this is putting a severe strain on the family in that we can't take our daughter out anywhere with confidence. She is also due to start pre school in September and, to top it all off, we are expecting another child in September!

The GPs latest step is to prescribe Movicol.

Does anyone have any practical tips or advice? Any experience of this situation? Anyone used Movicol? I think all I'm really looking for is some reassurance that one day our daughter will be normal in this department!!!!

Any pointers welcome!

Thanks.

I have no personal experience regarding this but just bumping for you. I know there are others who have been through similar issues.

While you are waiting for someone more helpful to come along you can do a little search of previous threads and you may find some information there. (top of the screen, click on advanced search, the next screen is fairly straighforward)

Oh and welcome to mumsnet. There is a "dadsnet" topic but the dads are most welcome anywhere at all on the board.

Movicol supposed to be good - gentle ,effective but not sudden .
Used a lot in elderly .
Also ,have a look at this
www.eastdulwichforum.co.uk/forum/read.php?29,492087
Good luck .

My niece is like your d as was her older sis,
for the constipation we used to give fresh juice [made by them or rather they helped]. Fresh oj an to get things moving carrot and apple it may help. TBH it lasted a while and seemed to be emotional as opposed to anything physical.
If she then has diarrhoea marshmallows help to firm things up [only needs to be a couple]

Can you sprinkle psyllium husk into drinks or food? It has the effect of bulking out loose stools and softening hard stools.

Adults tend to take capsules but I'm sure you could mix it into yogurt. Just make sure she has plenty of fluid to help it on its way.

My DD took movicol from the age of 4/5 and recently has been able to stop it at the age of 9.

It is not absorbed into the body but passes through to the bowel and attracts water to the bowel to soften the stool. Your DD will need extra water/squash whilst taking it. Initially you will have quite a high dose to empty her bowel and then you need to experiment to find a maintenance dose. I advise you mix it was water and a dash of squash as it doesn't taste that pleasant!

Have a look at a good website called something like childhood constipation.

Another tip is to sit her on a toilet after a meal. Rest feet on a flat surface. Then get her to blow some bubbles with those little post of bubbles. Do this for about 10 mins after every meal. She might not poo everytime but it does help.

Here

movicol paed seems very good at both clearing impaction and keeping things moving once cleared out. Assume it will take quite a while to get things back on track,and back in confident control, as if the constipation has been going on a while, the bowel seems to take a while to sort itself out.
Ds goes to a special paediatrician (the 'poo doctor')- and ds ( who is very much older than your dd) is at last fully in control!! Good luck.

DD1 was on Movicol from about age 3 to 4.5, I think. She still suffers occasionally from constipation (she's 6.5)) but can be sorted out with lactulose now.

Agree with the poster who said that you'll need to play around with the dose for a bit to find out what suits her best - DD1's paed expressly told us to do this, saying that the parents are usually the best people to work out the right dose for their child. It doesn't taste nice, but fortunately DD1 was old enough to understand why she needed to take this. I mixed it in a minimal amount of juice, as she wanted to be able to take it as quickly as possible all in one go.

It's not just about their diet, though, Eleanor. DD1 has a great diet, eats loads of fruit and veg but still suffered. DD2, on the other hand, would not knowingly eat anything green and has never had a problem. The paediatrician reckoned that DD1 had an immature bowel, and that things would sort themselves out as she grew. He would appear to be right

Movicol is the best. DS had terrible constipation and was prescribed it, it works a treat. For milder constipation we've used lactulose.

Hello mumbloke, we have used Movicol and it was brilliant. We had almost 2 years of 'witholding', in our case it was nothing to do with diet but a control thing that exacerbated to the point of no return - constant soiling, not going for 8/9 days. I gave ds (4.5) his movicol in orange juice. He mixed it up himself and called it the 'poo shake'
We were lucky that the poo problem (incredibly stressful, upsetting and taking over all our lives) was resolved properly in 6 months of starting the treatment.
Once his bowel had retrained itself (I think it's all to do with stretching and sensation) it was the psychological barriers we had to overcome and one day, bizzarrely, he just started going to the loo with no fuss.
It will take time, but don't be scared of the medicine. We found that stopping talking about the whole thing (making an issue out of it) helped too as it had just become and obsession with all of us.
Hang in there. It will get better in the end.

My dd is on movicol now....We put it in her bottle at night.....She has had bowel and re constructive surgery and the movicol helps her stool soften so as not to hurt her....Its all about trial and error though...too little has no effect, too much and KABOOM! EEK!....

Thanks to everyone for the tips.... some really good, practical feedback. Great to know we aren't the only ones in this boat! Never thought I'd be posting on Mumsnet before my wife!!!!

Well done, Mumbloke. Our little 'un (now 3) has been plagued with all this on and off for ages. Lactulose, as much jumping around as we can manage, wholewheat everything and water. All these sort of work. We disguise the lactulose in milk with a slosh of tea. She had a trip to the dietician who said she may had too much fibre. GP not convinced on that one. Bladder control is fab but she won't poo anywhere other than a nappy. Hoping for a breakthrough when she sees the others use the loo for everything when she starts nursery. Great to see other parents' experiences.

Mumbloke does she eat a lot of wheat? It gives me constipation (even the best organic wholewheat). Try oats,( DCS love the 'goldilocks breakfast). Or rye bread; you have to read the labels.

This sounds like encopresis to me. Often glycerin suppositories are needed to clear the backlog. There's a great book out there you can download, called 'Sneaky Poo' about talking to your child about all this ...

Another tip is to give pretty small plates of fruit when she is really hungry (she could help make it) but always BEFORE a meal never after.

DS2 has chronic constipation, despite eating his own bodyweight in fruit and veg.

Toddler diahorrea/constipation is common and the chances are they will grow out of it.

We were referred to a paediatrician after poor DS2 was hospitalised with a blockage at age 3.3. He was given loads of Movicol over 4 days then we went back to hospital and he was given a powerful laxative drink (picolax). That worked pretty well........

Because he was constipated for so long (they reckon he'd been like this for a year)his rectum dilated making it likely that his rectum would just fill with poo again.

Movicol treatment is necessary for at least 6 months to a year, to allow the rectum to shrink back into shape.

After the clearout, DS2 was on 2 sachets/day for a couple of months. This was fine; he was pooing normally every day.

We then cut down to 1 sachet/day, with 2 on a Saturday - did this for 3 months and he still pooed every day.

We are now on 1 sachet every other day, with 2 on Saturdays. Poos every other day,but we have to be careful in hot weather and he bungs up quite easily.

The paed registrar's son said her son (8) was still pretty prone to constipation, mostly if he had a run of birthday parties at the w/e. So she would give 2 sachets/day on Sat and Sun in anticiaption of this.

Her other top tips - always keep an apple in your car/bag as an emergency snack - the skin draws water into the bowel and softens poo.

You need a diet that is low in junk (white bread/ any processed food/no juice between meals).

Try and get as much soluble fibre into your DD - mangos are top of the list alongside peas. The soluble fibre draws water into the gut. Innocent do a smoothie with mango in it - but don't get the kids one as the 'bits' are filtered out.

Don't confuse with insoluble fibre (bran) which adds bulk to the bowel, but doesn't draw water.

Movicol is very benign, don't worry about any side-effects; just space out the sachets to morning and evening. Given together they can cause a sudden influx of water into the bowel whcih can lead to explosive poos!

I make it up in approx 10 mls of water and make sure it is all dissolved (will look hazy with no lumps) then top it up to 60 - 70 mls (don't need to be precise) with smoothie/juice. I then use a Nurofen syringe to make sure DS takes it all.

smoothie ice lollies are good snaeky fruit option.

Don't get upset or blame yourself if people get snooty because your DD is a picky eater.

DS1 is the pickiest eater (it's always your PFB ) and goes for a soft poo at 7am every morning.

With DS1 though I absolutely refuse to fill him with junky processed food. The paediatrician said it was the hidden fat in processed food that can bung the bowel - crisps/cheap sausages/ready meals.......

Jamie Oliver has a great pasta sauce recipe that you blend so the vast anmounts of veg in it become invisible. Add a pinch of sugar though to slake the tomatoes. The recipe is bulk so you can freeze loads of it.

HAs anyone suggested approaching it from the 'other end'. If the stool is hard it hurts and the child will not like straining against it.

A little olive oil in her bum to 'oil' the stool on the way out. A lot of fruit, veg and laxatives can build up behind a very hard poo and be uncomfortable.

Ask your GP about this, he or she could do this or a health visitor.

No personal expereince here but I know one little girl who was just like this, despite trying Movicol and everything, and being a very good eater of fruit and veg. Even an enema did nothing.

it was eventually proved to be a milk intolerance. Banning all milk and milk products for a while, combined with keeping going on the Movicol, worked. She can now have the odd milk thing - eg a yoghurt or an ice cream, but still generally avoids.

Just a thought.

My dd age 3 is on Movicol, our situation sounds very like yours, although our dd holds onto her poo. (and she is a very good eater) We have tried reward charts, and it seems to be helping a bit. She also is staring pre school in August, and out health visitor believes that is is when it will sort itself out, when she sees other children using the toilet. I just wonder if we are ever going to get her out of nappies.
Does your dd wear pull ups when you go out?
Not much advice really, just wanted to let you know your not alone

Yes; I second cakes and ale it can be a wheat and dairy intolerance you could try that Mumbloke

(picolax). That worked pretty well........ My son refers to it as dynamite he was like this stuff not working then ran for the toilet and there he stayed for next few hrs thank feck was old enough to air and clean bathroom after himelf