acute constipation and vomiting in 2 year old - any ideas on preventing it from happening again?

[CaptainKarvol]

DS has always (well, since weaning) had regular but infrequent poos - every 2 to 3 days. Not ideal, but it didn't seem to have caused him any problems until today.

He woke up and vomited this morning at about 5am, then another 3 times this morning, and hadn't had a poo since Sunday (5 days ago).

I took him to the docs who prescribed lactulose and glycerine suppositories. The suppositories worked within about 10 mins, but just one little poo (very soft), not a weeks worth!

Our lovely GP gave us another appointment for this afternoon if I'm still worried, but was just wondering what I can do to help DS. He eats plenty of fruit and veg, always has brown bread... I don't know what to do for the best.

Oh, and my washing machine has just broken down, great on a day of poo and vomit and with the week's washing to do!

If the poo is soft he's not constipated.

Prob got a vomiting bug that has slowed down his bowel motions.

The stimulus to poo is food leaving the stomach and entering the small intestine. If he's vomiting then food is NOT entering the small intestine so he will not want/need to poo.

Careful with the lactulose - you can cause diarrrhoea with too much!

Actually, I think the poo can be soft and he can still be constipated, having just been through this with DD (just over 2 years old). We had a long conversation with our doctor and got a (troublingly) detailed leaflet on toddler constipation from him.

In essence, if your DS suffers from chronic constipation, what happens is a couple of things. Firstly, they can develop anxiety about pooing (because of pain involved) so will hold it in longer than they should. Secondly, if they suffer from it regularly, the rectum becomes distended such that (a) more gets blocked in there (b) the need to poo gets smaller/ harder for them to recognise and (c) actually pushing the sutff out becomes harder for them (physically). Once they do poo, all that happens is that all the stuff behind just drops in behind it, and the rectum doesn't have a chance to get back into shape.

Ironically, once constipation has started, giving high fibre foods etc. actually makes the problem worse (which is exactly what we were also doing) - the fibre is blocked by the existing digested matter, ferments in the gut and releases gas which causes more pain/ cramps and makes pooing even more painful.

What the doctor and leaflet advised was to continue giving lactulose (twice a day) for a period of a couple of weeks, along with a healthy diet to allow the gut (and rectum) to clear and regain its normal function whilst getting DD used to pooing normally again.

Just as an aside though, although it used to make her sick, it wouldn't normally be as much as three times in a day, so as gagarin says, it may also be some sort of stomach bug as well.

that is really interesting, thank you both. I had thought that it couldn't be 'true' constipation because the poo was soft, but everything else about it seemed like constipation... Poor DS was so ill with it yesterday that the GP phoned us at home in the evening to see how he was / whether we had ended up down at the hospital. We're going to stick with the lactulose, plus the suppositories if no poo has happened for 2 days. I agree that his bowel does need to get used to being emptied. Wish I'd been to see a doc sooner, but hopefully we'll be OK now. Thanks again.

Thought you might like to hear about my DS who is now 5. For what seemed a very long time suffered with constipation and a very bloated tummy. For a long time I thought he may of had a gluten intolerance - the test he had for this was negative(even tried a gluten free diet). His tummy would become very hard and go for days without doing a poo. He would not settle at night - saying his tummy hurt and his bottom hurt, even crying in pain. We would spend hours with him sitting on the toilet encurouging him to go. After months of this I took him to the doctors who precribed lactulose (a high dose) and sennacot. I used the sennacot with care and he needed to stay on lactulose for about 2 months gradually reducing the dose. Plenty of water and drinks and slowly increase his fibre intake (apples and pears with skins of are very good). Hi Fibre White Bread and Hob Nobs are also high in fibre.
He now seems to go most days and not frightened of going anymore. I just make sure he has a balanced diet and drinks plenty and even ask his teacher at school to get him to drink water.

Hope this may be of help to you.

thanks Kezzagold, it's good to hear that things worked out for your DS. I've tried the gluten free thing too, and settled on a cow's milk free diet for DS, so I know just where you are coming from. I'll keep on with the lactulose and hope it works. Maybe it will help my DS's sleeping too, last night (post suppository induced poo) he slept through for the first time EVER at 2 years and 1 month old!

Good luck with the lactulose. My DS did,nt sleep through the night until he was about 4 years old.