have just spent the morning at the gastro clinic with DS2, he is back on senna (sad), and also been referred to psychologist....what can I expect????

[Psychomum5]

DS2 has suffered with bowel probs since birth....he has now finally had a 'formal' diagnosis (if you can call it that) of 'chronic constipation, bowel dismobility and IBS.

he spent 2wks last summer in hospital having to have strong amounts of senna and movicol to 'clear him out', which had a nasty effect on him and he became incontinent. he was also referred to a psychologist as he became scared of doctors, but nothing came of it and we heard nothing.

anyhoo.......by october he was a 'normal' 5yo, no bloating, no constipation, no diarrhoea, happy!!!

then, 4days later we had our car accident, and all went back again. the pressure on his belly from the seat belt during the crash made his belly go bad again, and 6mths later his bowel is back to how it was before the admittence last year....so......we are back on senna again, without the movicol this time, but still, senna has had such an awful effect on him before and I am worried and scared for him......I am tho going to start him ona very low dose to hold off the explosions (I hope).

also he has had another referral to the psych, as they are concerned about his ability to cope at school when his tumy is bad, plus he has had lots and lots of bad dreams and bad night since the crash so that isn;t helping his belly.

We also have concerns re-school, and his teacher has mentioned twice now about referring him for assessment for ADD and dyslexia....which his doctor is concerned about but hopes for the school ed. psych to look nto that....is that true/poss......would the medical psych not look into that all too????

what can I expect from the psychologists.....and will they look into the family as a whole or just DS2???

sorry for length, and TIA

Have you tried all the other non-drug ways to get things moving?

The psych sounds like a good idea if he is not coping very well. They'll just talk to him and work out a way which he can express how he's feeling. Sometimes they do talk to the family, it gives them an idea of how things are at home. Don't take it personally, they are trying to find the best way to help him.

Oh,
have no experience but fee really for your little lad. poor chappie. Sounds like he a sensitive little soul.

Im no expert in paediatrics but I Know that for adults, movicol is preferable to senna as it does not ittitate the lining of the bowel, it works by keeping the motions nice and soft (sorry if Tmi) the crucial thing is though that you have to adjust the dose until you get it 'just right'. Ie some people need two sachets a day, some need one, some need 1/3 etc etc. I know what you mean about it causing incontinence, that it a sure sign it needs reducing down.

Hope all goes well.

thats what I thought, and I am ok with the 'whole family' approach, but my DH is a little sceptical to say the least.....see's it as DS2's problem (in a physical sense rather than the psychologicla impact all this has IYGWIM), and so isn;t overly impressed with the thought of it all!

he does get that psychology can have impact on things (he has too....he see's how I am since the crash on my issues.....he had to drive us there today as I was being sick with fear this morning), but he reckns a 5yo can;t have psychological issues......

as for the 'over the counter meds', is there any??? he doesn;t get on with the liquid laxitive (cannot remember the name) that the GP prescribed......hence the senna.....tis just that altho the senna does work, it works TOO well IYGWIM, and the last time made his bottom so sore it bled. plus of course he ended up in pull-ups which I am desperate to avoid as TBH, he has missed enough school and if he gets incontinent again, he can;t go to school as that is unfair to everyone!!!

arghhhhh

why no movicol??? I remember the nice man's powerpoint presentation, and without the movicol, if he is constipated then it will be just one bloody great hard lump which will hurt

(you do know if you had mentioned why you wanted me today, I could have rearranged )

(can come over now until I have to collect Boy btw...)

Is there anything coming out or is he just a little bunged up? (sorry, I know it's too much info)

flame.....I didn;t know I would end up being sick with fear tho.....I was nervous, not terrified, last week!!!

and yes please to vist

would've come for nervous

Just got to add 2 things to shop, and will load up the dude

avenap....he does still poo, thats the things, but he vears from over-flow type poo (which means he has a bunged up lump), to a 'normal' poo thats is massive and makes him bleed.

he then gets bunged up again as he is hurting and scared!!!

oh, and he smells too......farting lots and very bad wind type smell!
and a bloated tummy

ho hum.......am off to docs in the morning with him tho, as the hospital gave me a letter to give to MY doctor to fill the script, and will ask for movicol too me thinks.....oh, and other stuff maybe.....

am waffling, am tired and twitchy and sad!!!

Persuade your dh that the whole family seeing a psychologist is a good idea (IMHO). Looks to me like there's a physical illness plus bad luck (the crash) having a really bad effect on all of you (as you'd expect) and surely it can only help to talk about all the repercussions. Your poor ds - every sympathy to him, and to you

What's he eating? How much is he drinking?

sooo......going on that (re persuading DH that it is a good thing!), how long do you reckon a referral takes??? how long do I have to 'work n him' ?

I know it won;t be instant, but still, I don't want to work on him NOW, only to find he doesn;t remember the chats we had when the times comes and I have to fight all over again....

(DH has an atrocious {sp?} memory.....he cannot remember things from one day to the next, let alone weekly/monthly/yearly)

My son was a bit like this. He would hold in his poo for days nd then would let go of this hard hard stool and vomit at the same time. At about age 6 or 7 he was staining his pants as he would hold it in etc. We got referred and by the time an apt came up he seemed 'cured'. Basically I think his increasing age and the penny finally dropping that holding it in is not a good idea did the trick. DP did a lot of lecturing on why he needed to let go etc.

I think poo and eating problems are hugely psychological. I have two friends whose kids are very similar.

On a practical level I found the following helped with the constipation:

1. Lot of oats
2. Prune Juice

DP and I both have bowel issues - IBS etc all of which is linked to stress and to a lesser extent diet.

My mum has bowel problems, she takes senna and fibragel - it's a husk/powder that you add to water and drink - she also has a solution (can't remember what it's called, but can find out later if you like) which she syringes up her bum when it's time to 'go'.

The senna and fibragel makes her poo soft and the injected solution makes her go then and there.
She does this every other day.

avenap.....eating is terrible....always has been.

he was allergic to milk as a baby and was on pregomin formula up until he was 4, and even now has soya to drink and in food as he will react (now intolerant rather than full allergy reaction IYGWIM).

he was also thought to be coeliac for a long time and on gluten free food, altho there was no huge improvement, and so, because of all the messing about with food when smaller (he has only been on 'normal' food for about a year), he is extraordinarly fuusy now.

he eats, and is growing (is now 3st and 109cms), altho still the smallest in his class, but that is more on 'crap' rather than wholesome good food!!!

I will give him the same as us, but he is extremely selective about what he will eat, and to be honest, it is easier to give in at times as otherwise he will be sick (and he does too)!

oh, and potatoes.......big big no-no.....he vomits each time he has any, and that is if it is hidden in foods too.....doc says very unlikely to be allergic, so we think psychological effect as he used to be sick so often that textures get to him now.

Dairy products can often be a problem for children. I'd say from the experience that I've had with kids and their tummy's that this is part of the problem. Are there certain foods that make him worse? Have you had any input from a dietician?

Your poor DS, it sounds dreadful.

Have you heard of FOS (fructo-oligosaccharide)? It's a natural prebiotic and is safe for children. Might be worth a try, particularly as it's so easy to take (looks and tastes like caster sugar). It solves my DD's occasional constipation and has no habit-forming side effects unlike laxatives.

Obviously it won't solve the psychological issues but it might ease his discomfort.

I need to type quicker......I take so long answering one that more pop up.

fybergel??? How does that taste....he has to have meds disguised in drink/food and is quite suspicious so am always on the look out for stuff he will take without realising.

and will investigate prune juice too, thanks for that.....I used to get him to eat dried fruit, but he is now refusing more of those now, so something I can put in other juices is a great possibilty

dietician was worse than useless......told me to just carry on offering and he would get over it in his own time....oh, and just force him to drink cows milk too as he will get used to it eventually anyway!!!

well.....no to 'getting over it'....if anything he is worse. TBH tho, some of that is ME, as since th car accident I have taken a long time to get back into normality and so it was and has been easier to let him eat how he likes IYGWIM. his habits seems more fixed now tho.

oh, and cows-milk........we tried, he did well until almost full milk (we did the gradual mixing so as to get him used to it slowly).......he started to vomit and became really constipated! he now prefers the taste of soya, and as I am seriously allergic to milk (I go inot allergic shock with it), and DD2 and DD3 is the same as DS2, soya milk is no hardship....I go with it.

so.......practical help with better support would be better, rather than telling me IYGWIM

he's got himself in a cycle, he's afraid to poo because it hurts so he holds it, then it hurts and he doesn't want it to come out. There's the added stress problem on top of this (feel free to correct me if I'm wrong). I'd avoid the dairy (I know it's got calcium in it but so has spinach etc), just for a while. No cheese.
Right, the basics: What he eating at the moment? I know you've said it's rubbish but I need specifics. If he's not drinking enough this can make the poo hard aswell.

My ds had retention and overflow, eventually solved by liquid paraffin - check with your gp first as I think it isn't recommended for younger children without supervision. The psychological aspect is important, for a couple of years the build up to a poo was like 3 days of pms every week! Good luck with getting it sorted.

Has he been x-rayed or scoped?

A friend of mine had all sorts of problems with her ds- eventually he was properly investigated this year aged 8 and he has severe crohns (lots of ulcers) and he's been having very full on treatment. It seemed to take years for the investigations though.

Another friend recently had her ds's bowels investigated privately. I can get you the doctors details if you want.

If he has been like it since birth and has ADD/dyslexia things going on too it might be worth making sure that a proper in depth physical examination of the gut has been carried out.

The fybergel tastes orangey, but it is quite gritty so you may have trouble persuading him to drink it if he's fussy.