Constipation/fear

[twinklebutt]

Posting here for traffic! Hope that's OK.

8 year old DD.
Constipation, purposely holds herself, daily accidents, absolute FEAR of going to the toilet.

Sensory issues, refuses to take senna tablets, gags at movicol (although still taking upto 10 sachets a day).

Currently on 4.5 weeks of no actual bowel movement!

Docs have no appointments, I can't physically make her go.

What can I do? Any advice?

She's on up to 10 sachets a day and has no bowel movements for 4.5 weeks? Not opened the bowels, do you mean?

Just a bit confused as you said daily accidents. X

Would you be able to give her 'ella prune pouch' mixed in a chocolate milkshake?

Although it seems that it more a 'behaviour/ sensory' issue. Is she afraid of going to the toilet?

Has she been scared by playground tales of monsters coming up from the toilet?

Absolutely agree with the PP above regarding Ella's prune pouch. They were a life saviour for my DS when he was younger with severe constipation.

Are you talking to the help line via the ERIC website?
Also, if you haven't watched the poo nurses' video do that asap. Their advice is excellent.

Join movicol mummies on FB. You’ll get people with lots of experience rather than the hopeless suggestions of prune pouches

Ah because we suggested prune pouches - must be hopeless and means we have 0 experience. Great assumption - I like it.

It sounds like impaction with overflow. You mention sensory issues. This is significant and you really do need specialist advice and support. It is a complex issue and will take a long time and a lot of support to fix.
You give very little information in your op, so in order not to waste time, it would be best to access the specialist support suggested asap.
This is a psychological and emotional, as well as a physical problem. It takes time and effort to treat.

Can you contact the school nurses in your area they may be able to do a referral to bladder and bowel services. GPs are often not up to speed on managing severe constipation with sensory issues

Isn't 4.5 weeks of no bowel movement an emergency??

OP says daily accidents, so it isn't clear what exactly is happening. Perhaps she means no formed stool, or no use of the toilet. Daily accidents could be soiling with overflow. It is difficult to to tell.

Sorry and thank you all for the advice! Sorry for the lack of info initially.
So she is having either overflow accidents or she is attempting to hold it in when desperate and small amounts are coming out in her underwear. But not sat on the toilet to pass anything bowel wise!
I would have thought by 4.5 weeks there would be some urgency in supporting her to go.... But no!
I finally spoke to the doctor who wasn't concerned, annoyingly!! Now have lactulose, senna and movicol and a referral to the constipation clinic.

Thanks for the super ideas. I'll try anything. X

Fab advice thank you. I'd not seen this website before. Its great.

I'd not thought about the school nurse!!

Poor you, OP. It’s a bloody nightmare.

Great that you got a referral.

Definitely join Movicol Mummies. So much good advice there and it’d be a source of support for you - it’s very lonely and stressful, as I know from experience.

Call the Eric helpline, or email if you can’t get through. You don’t say how much medication the GP said for her to take but it sounds like she needs a full disimpaction regime. The Eric website has lots of advice on this.

Senna is the first line stimulant that they add - sodium picosulfate is stronger and that’s what a lot of people end up on.

Don’t forget that you need lots of fluids alongside the Movicol, in order for it to work. It will feel like a full time job, getting fluids and Movicol into her.

When things were really bad, I used pantiliners in DD’s knickers for leaks, to help with laundry and changing.

Very best of luck.

My first thought is to look at what's happening in her life to cause the sort of anxiety that makes the body tighten.. and then putting everything in to gently relax her.

Guys I can't thank you all enough. I've joined movicol mummies on Facebook today and the advice is amazing!! As is yours on here.
Anxiety wise I wish I had answers, she's currently in an 18 month waiting list for CAMHs! This is adhd/asd/anxiety exploration.

Panty liners are a fab idea. We have on occasion used them when going out. Xx

When she's sat on the loo (assuming she will?) have her feet supported so her knees are higher than her hips (footstool, upturned bucket whatever). Lean forward with elbows on knees. Oh and get her to blow bubbles or blow up a balloon. Sounds nuts but it works!