Painful stools

[ThomCat]

Not a very pleasant subject so sorry about that but just want some advice from you girls if poss.

Due to the low muscle tone in children with Down's Syndrome going to the toilet can be a difficult process.
Charlotte passes a stool about twice a week - ish and it's always rock hard and very painful for her.

Anyway I had her at work with me yesterday and she started to make her 'oh no I'm having a poo' cry - an unmistakable cry that tears at my heart. It took about 10 minutes to come out - I had her over my shoulder with one leg bent right up and I had to really help her get it out - and it made her bleed. Ugghhh, sorry - pause while my stomach unknots. It's so distressing for us both.

Anyway what I want to ask is - apart from the high fibre stuff - all bran, prunes etc - what can I do to SOFTEN her stools to make them less painful to pass? I know about lactulose but she is a nightmare to give medicine to - a REAL nightmare - it just goes everywhere and you end up having to give her 3 baths a day as it's like glue and gets everywhere including her hair so it's a really messy job.

Any other ideas girls - please???

I've posted this on SN as well - just so you know.

Thomcat xx

Oh poor little Lottie No real advice but sympathy. I'm sure someone will come up with good advice soon

Keep smiling

I was going to suggest lactulose but have just seen that that's not really an option. Have heard orange juice is good - not sure what your views on giving juice is, of course - give diluted to my younger dd who also has v hard stools and it seems to help a bit. Sorry not v helpful. It's so horrible to watch and it must be so painful. My dd cries and cries. Would diluted syrup of figs/prune juice be too much? Sorry, not really helping at all.

Sykes - do the oj and the prune juice actually soften the stools though? I usually only give her water - never been down the juice route but will do it if you think it'll have an effect. So freshely squeezed orange juice yeah and then could I also just buy tins of prunes and give her the juice in that to drink as well??

Well, it seems to help my younger dd who is nearly two. You can buy prune juice in bottles, which I've used just once or twice when dd hadn't had a poo for nearly a week and it seemed to help - she didn't strain quite as much - sure you know the crying, red face and really pained expressions. Others may have better advice. Hope I haven't given you the wrong advice. I tend to give diluted o/juice if I think it may help. Could you flavour lactulose as a drink? Is that a stupid idea?

ThomCat, my sons have been prescribed Magnesium for constipation. It really seems to work. We're in Switzerland, so the brand might be something different, but it's Magnesiocard 5. I mix it with orange juice (it's orangey) and the boys love it. If you can't find it there, let me know and I'll post you some.

Thomcat you can buy prune juice in bottles at the supermarket. It's VERY effective. Hope it helps xx

Ok - well I'll go and get prune juice this lunch time as I can do that straight away.
Sykes - no not stupid and that's what I did for a bit but was told when it's diluted too much it has no effect and when i gave it to her in a bit of water she just blanked it straight away. Maybe I'll try mixing the lactulose with prune juice so it'll soften the stool at the same time as making her go.
The trouble is where she goes so infrequently it gets really compacted and she know's it's going to hurt and won't even strain to get it out, she tries to stop it coming out. It's so upsetting - poor little lamb.
JJ - Never heard of it over here. i'll look it up on the net at lunch time and get back to you on that - thanks a lot.

Poor Lottie. Hope it helps.

My midwife said after I'd given birth and was having similar 'issues', to get a tin of prunes, heat gently and eat with custard. Absolutely delicious and really not like medicine at all. It worked a treat too.

Well went to the pharmacist and she said as there was blood there yesterday she wouldn't give me anything and we should see doctor. Bought prunes in fruit juice and a bottle of pure prune juice and already have dried prunes at home some of which I soak overnight in a little water anyway so she takes in additional liquid. She drinks a whole Avent bottle of water a day, at least, plus her milk in the morning and evening.
Will see what doctor says but will also go to cranial osteopath and try a homeopath as well.

Oh dear, poor Lottie . I can't add anything to the suggestions about juice intake. But have you tried lying her down and moving her legs round as if she's on a bike when she's straining? It helps my ds if he's got a bit constipated and is straining to pass a stool. Also, baby massage on the tummy might help. You are supposed to massage in a clockwise direction.

HTH.

Thanks gingernut - yeah do all that. Trouble is they are huge, and I mean huge and so rock hard they could knock a man out!
Big thanks for all your concern, advice, support etc. Mumsnet at it's best.
I'm still open to suggestions as and when girls - thanks a lot - TC xx

Poor Lottie, my son used to be like this, and even now at 16 he only goes twice a week. He also tends to block the toilet as it is so huge, so I know what you mean about size!

We had to go the Lactulose route, as the playschool leader got fed up of trying to help his poo out during a session, I don't know why but he always wanted to go at Playschool and they'd be in the toilet for half an hour, she ended up having to pull it out, poor woman!

Blood would also suggest she has a little tear, we used to put vaseline up his bottom to help ease the pain when doing the poo.
Trouble is they associate pooing with pain and it becomes a viscious circle and then they will hold onto it as they dread what is going to happen.

No other suggestions apart from the prune juice, dried apricots can also make some children quite loose, and they like eating those as they are sweet.

Hugs to you both

Thanks Alibubbles - yes actually I do dried apricots with her as well. Nothing seems to work so far really and as you say she now associates poo with pain which is just what I didn't want to happen.

Have a look at this thread . If your dd's poos are very big (which could be because she doesn't go often, but not necessarily so) then please be careful about adding fibre to her diet, as when I did that my poor ds got into terrible difficulties.

TC it can also be related to mobility. Rory's seems to be down to the fact he is less mobile than others, therefore the gut doesn't work as well in expelling the waste (or something like that)- bleurgh. His are enormous too, we call them football poos. Am constantly amazed that anyone let alone a 2 1/2 year old can push out anything that big from that orifice!

lou - yes mobility definately comes into it as well. She's barely crawling so.....

Boyandgirl - bless you and thank you. It must sound from my list that all she eats is fibre - not true though. She has weetabix maximum of twice a week and when we go through a bad patch like now I add all bran to it too and prunes are only a couple of times a week. I mix wholemeal and white bread up so she gets a bit of both.

Thanks for that link though, I've printed it off and will take it home and make a note of all natural remedies that may help her.

I added the link without rereading it, so I may be repeating things, but if mobility is an issue have you tried swimming? It helped our ds a lot. Also olive oil is good for improving gut mobility, and oat bran is much gentler thhan - but as effective as - wheat bran.

Boyandgirl - I have taken her swimming but not for a while - the Aquatots class put me off! So if I take her and just swish her round in the water in my arms that should help should it? I do give her v.warm baths in the hope that will help her a bit sometimes.

Have oat bran at home so will sprinkle that onto normal cereal as well.

Noted the olive oil bit and will try this. I use it in all my cooking anyway but will try adding some in addition to her food.

Have printed off all threads on this subject to take home and digest (ha - pardon the pun!)

ThomCat, for milder cases I eliminated bananas, rice, apples and toast (BRAT) on the theory that since the BRAT diet is recommended for diarrhea, eliminating those foods might help constipation. (Hope that made sense.) Too many bananas, especially, seem to stop my guys up.

We had a little song, too:
Prunes and oatmeal,
prunes and oatmeal,
they taste very good together.
Prunes and oatmeal,
prunes and oatmeal
Hopefully they will make you poop.

And now I'll have that running through my head all night....

JJ - LOL

She only has a banana every now and then and even then she only eats about half a small one and the rest goes on the floor.

She never has rice.

She has apple about once a month - she's not a fan - prefers peaches, melon, plums.
I did however stew some apple last night but used freshly squeezed orange juice to boil the apple with instead of water.

Toast - can't cut out her morning slice with marmite she'd go mad. She barely eats her cereal as she can't wait for the toast. But she does only have that 1 slice all day - I prefer to give her 2 meals rather than sandwiches at lunchtime so she doesn't eat too much bread.

Anyway - I printed off all the threads and went home and wrote out all the great tips / advice in a book and have started her on the prune juice (hope she likes it).

Her lunch consists of sausages and mustard mash with veg and yoghurt and bits of cheese and cucumber to snack on and tea is fish with sweet potato and veg, stewed apple in oj.

Will make appt to see GP next week and will try and find a homeopath asap as well as booking her to see cranial osteopath. Will keep on with prune juice, stewed and dried prunes, dried apricots soaked in water, will sprinkle this oat cereal stuff on her normal cereal and willl add lactulose to her water anyway although not sure of effect when so diluted but worth the go anyway.
I won't do all this at the same time, but one of them a day and something there should start working soon hopefully!

Thanks for everything girls. xx TC

Dear little Thomkitten - she won't know what's hit her! Hope you find a solution soon.

BTW, I think that it's the bicycling movements and froggy kicks that babies do when they swim that gets the bowels moving, so we used to tickle ds's toes under the water or bounce him horizontally off ou chests (one chest at a time, IYSWIM!).

Well she's been a few times since that really awful one and although she's not been finding them easy they are a lot better. Still hard but not as hard and the fact she's going a bit more means that they won't be so compacted.
Porridge (well oats-so-simple!), fish, prune juice, sweet potato, dried prunes and apricots, oat musalie bar, yoghurt, pasta & pesto, veggies, chicken and evian water are all on todays menu!

Hmmm, little Thomkitten - never called her that before - will start tonight!!

Thomcat!!! After two months! Finally found the bottle of the natural stool softener!! It is called ISPAGHULA. They are made by a company in France! This is the information on the bottle:

ARKOCAPS ISPAGHULA 100 Capsules
Distributed by Arkopharma US, New York City, NY 10956.
From the bottle:
Use as a supplement to your daily diet. It can also be taken by mixing the powder into hot water and drinking it as tea. Take one capsule with each meal or follow the advice of your health professionals advice.

I am not a doctor for sure, but what I did for my daughter was to give her less than a 1/4 of the capsule of powder in some pudding (something she liked) starting once a day in the evening. Sometimes that was enough to do the trick, if not, I would give 1/4 capsule of powder at lunch and dinner. Make sure your little one is drinking enough also. I thought this stuff was fantastic, so it may be worth a try. It is derived from the husk of the Plantago Ovata seed!! I found it here for you: www.worldwideshoppingmall.co.uk/body-soul/ispaghula.asp
The company website I found is: www.electramed.ie/arkopharma.htm
look in: www.electramed.ie/ark_digestion.htm to find the Ispaguhula recommendation for constipation==I didn't even know this was used when dieting or to lower cholestoral!

Here is more info from the web: www.electramed.ie/phytofibre-ispaghula.htm

Phytofibre-Ispaghula
Plantago ovata

Recommended for
SLIMMING DIET (HELPS REDUCE THE APPETITE AND SLOWS DOWN THE ABSORPTION OF FOOD - CONSTIPATION - HELPS LOWER CHOLESTEROL AND TRIGYCERIDE LEVELS (REDUCING THEIR ABSORPTION)

Presentation
430 mg per capsule of total plant cryoground powder, 20% of mucilage

Part used
the seed husks

THE FIBRE EFFECT :
Ispaghula is a plant belonging to the Plantaginacea family which often grows in Pakistan and India. The teguments of the seeds are rich in mucilage. This forms in the stomach, when mixed with cold water, a gel which is not assimilated by the organism but which has multiple benefits. Ispaghula is particularly appreciated during slimming diets for two main reasons : firstly, it naturally takes the edge off hunger ; secondly it slows down the absorption of food during digestion and especially sugar and fat therefore minimizing calorie intake. This high viscosity gel is beneficial to re-educate the intestinal tract which breaks the vicious circle of "classic" laxatives. It increases the volume and the hydration of the stools, making their elimination easier. Also, by covering the intestine walls, it has a protective action. This gel can also absorb bile salts which will be then evacuated along with the stools instead of being held within the intestine. So, the liver will have to use cholesterol to make more bile salts and in this way Ispaghula will reduce the cholesterol and triglyceride levels.

Please remember for slimming : can only be used with a calorie controlled diet.

Dosage (For Adults on this website!)
Take 2 capsules with a large glass of water before each meal. The intake can be increased to 4 capsules.

Thomcat, aside from the prunes and all bran, which are good, are you also staying AWAY from bananas and apples? I haven't read all the posts here, but you may want to make sure she is not eating foods that are causing her poos to be hard. I think that too much dairy and carbohydrates and not enough fruits and veggies worsens the situation. Good luck! DD also has occasional difficulty, but usually, we can give her some juice or increase water and fruits, and that helps. I also never give her bananas and apples.