My 4yr Old Daughter has been diagonised with a Floppy Rectum Help Me!!!!!

[Kelly42829]

It all started when she was about 2 1/2 yrs old, when we started potty training her. She first started to hide when doing a poo or would only poo when she had a Pull up on. I took her to see the GP as i noticed that she was holding her poo in so it wouldnt come out. They precribed Senna & Lactulose and at 1 point she hadnt been for 11 days so I took her to the GP and was giving Movicol and suppositorys to clean her out and then was told carry on using this as and when nesecessay. All the time being told that this is just a faze that they go through. In the summer we went back to the GP and asked to see a paed as when she was doing a poo it wasnt anything substancial and would always be in her pants and we wasnt sure whether she even knew she was doing it. When we saw the paed he said that she had a floppy rectum and thats why shes is only doing small poo's and was given lactulose and senna again and to basically trial and error to find the correct dosage for her as he wanted her to do a substancial poo everyday. We started off with 10ml of lactulose morning and evening and 2.5ml of senna morn and eve but we ended up having really bad Diarrhoea and this was a week before she was about to start reception and I really didnt want that to be happening at school for her sake. We took the dosage down to its lowest and gradually increased to try and find the right amount but now her poo is a soft consistency and is just coming out if her like little slug marks if that makes sense and I know if I up it anymore she will have it running down her legs again. Sometimes i feel she does feel it coming out and sometimes I think she doesnt. Its so hard!!!! I monitor her poo's as best as possible and she is basically doing 1-4 soft stools a day the size of a grape!! Is that enough??? Her school always cleans her but when we went to parents evening this week the teacher spoke to us about her accidents and sometimes can change her or assist her up to 6 times a day and she said maybe it would be worth while we went back to the paed to explain whats happening with the meds she is on. She commented about everytime she has an accident its means a member of the teaching staff are out of the classroom etc and made me feel like it was more of an inconvience for them than it was for her and I was quite upset. She said she had spoken to the senco and she doesnt seem to have any ideas. She said that she thinks that the children around know she goes to the tiolet more often however there isnt any teasing as present but she doesnt want her self essteam to knocked etc. We are starting a chart when we return after half term that she does at school and brings it home and gets rewards for no accidents but i dont know whether its out of her control anyway so a chart isnt going to work. Anyway we are back to see paed next week. Just dont know whether lactulose and senna is doing the right job cause dont want her to have the runs or to have repeated accidents of soiling 1-4 times a day at school. Any ideas or advice

Oh, Kelly how I feel for you!
DS, now 20 ( so it will get better) had a similar problem as a baby /toddler.
He got constipated at under 1 yr old, one doctor (private) just said 'Give him more water'. The GP said if he had an anal tear 'It is like shitting razor blades'.
Me and DH were at our witts end worrying about our young baby.
In the end we saw a paediatrician who had him on 30 mls lactulose a day and 10 mls senna a day to start to get him regular (be bloody hated it, and was gagging and trying to throw if up to start with)and after maybe 6 months we started to drop it by 5mls a month. I'm not joking, but this took about 18 months going backwards and forwards by 2.5 mls at a time at the end to keep him regular. In the end going back at 0.5 mls at a time.
At the end of the day our child ended up going to school with no bowel problems,but only because of this brilliant paediatrician that understood his problem.
It may take a while, but you have to get the laxative sorted so they are comfortable going to the loo and hopefully they will get it and understand so that they can go through life as a normal functioning person

When your child was having the 30 mls of lact and 10mls senna was he getting the runs? As the most my daughter has had a day is 12.5mls of lact and 10mls senna and there was just poo everywhere and obviously I dont want this happening at school

Kelly, google diarrhoea overflow.
This is what DS had when he was constipated, and I wonder if this is what could be happening to your daughter.
DS had 2 enemas on the childrens ward on the first 2 occasions he saw the paediatrician, and he didn't poo for 24 hours after the first one and about 18 hours after the second one. The doctor and the nurses on the ward when we went back the second time couldn't believe it, but the doctor said that is a baby who can really hang on to his poo as it hurt him to go.
The enemas, I suppose got the ball rolling (so to speak), but in the end it was the large doses of laxatives that did the job, and the consultant wasn't worried that it would have any long term effect which it didn't.
It did take a long time to sort it out, but for you it is now a case of getting your daughter to do one good poo a day, and to stop the soiling. When DS was very constipated I would change his nappy and then a few minutes later would smell poo again, but what this was, was the diarrhoea overflow. Could this be what your daughters soiling is?
It was the health visitor that first mentioned diarrhoea overflow to me and explained what it was.
Do you still have HV's for under 5's who might have some advice.
Good luck!

Kelly, have a look at this article.
Seems to describe my DS all those years ago and maybe your DD.
www.patient.co.uk/health/Constipation-in-Children.htm

Dont know whether its just me but what part of the article are you talking about? Thanks Kelly

Kelly
What about the idiorathic constipation bit with the diagrams of the floppy rectum being blocked with the hard faeces with diarrhoea overflow.
Could this be what your daughter has and it is not the laxative which is making her soil, but the diarrhoea around the faeces.
Maybe the laxatives you are giving her are still not enough to shift the impacted faeces.
Maybe it was my sons enemas that started to work for him then the increasing laxatives to make him regular, before then starting to very, very slowly reduce them.
Hope I've given you some more thoughts that may be of some help for your little girl.