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

Turn it into ice pops.

right....will answer yurt for a mo, as that is easier.

xrayed last year, and the year before that. He has a 'large dismotile bowel with large pockets of air'.....it is three times the size it should be!

scoped (I guess you mean camera down)....he has been down on the list for that three times, and should have been done last july, but he reacted badly to the senna and so it was not done, and I think they forgot. his imflammitary levels are normal, but his iron keeps going low and he is also deficiant in vit D (oh, I forgot that until today as they told me on my last visit there 4days before the crash.....could that make a significant difference....I think they thought I was doing something and I lterally just remembered).

erm.......oh, his tummy is that bloated his tummy muscles have separated....they mentioned fixing that, but then decided that they need to stop the bloating first as obviously no point fixing without sorting out why he bloats IYGWIM.

crohns I think is ruled out for now, but a good friend has a son with crohns, and all she keeps saying is that MY DS2 is exactly the same as her son was at the same age!

icepops suggestion sounds good

Fybogel tastes like wallpaper paste!

His bowel will be larger then it should be because of the constipation. Have you tried giving him coffee? It's a very good laxative (caffine's a bit of a problem though!) Soft ripe pears are also good. Make sure he's had plenty to drink. His diet really won't be helping. Try and identify what types of foods cause his problems. Have you tried a reward system for when he goes to the loo?

Fybogel: You should be able to mix it with some orange juice and freeze it.

food....

I will write what I cook, and what he will eat off his plate...tis easier in my mind then

breakfast is easy as he will eat quite well....cereal, pancakes, waffles, yogurts, fruit etc. plus apple/orange juice to drink

lunch is lunch box at school and we give him tuna sandwich, crisps, biscuit, fruit, humzinger, water and a carton of juice as the teacher says he won;t drink just water.

after school.....fruit/yogurts/biscuits/more breakfast cereal.

dinner...this is the hard part...

I cook roast, he eats only the yorkshire pudding and gravy.....ignore meat unless I do sausages.

spag bol......will eat plain pasta and the bread roll!

anything that has baked beans on the side.....will eat the baked beans only

ermm...will think on more and be back....flame here and handing me calm down coffee

OK. My DS2 has had bowel problems since birth (he is now 22 months) and we have been really lucky in we had a fantastic consultant and have made loads of progress, but the one thing to remember is that if it hurts to poo they can stop themsleves and that can make it worse [sad}

Lactolose works well for us (although it does cause bad wind). Stool softners are really imporatnant, as the longer the poo stays in the body the more the bowel withdrawers mosture from it, leaving it solid and really hard to push out and it can also split their bum.

SO it our case, we manage mainly with diet, ceral for breakfast, loads of fruit and veg. Banana bung him up, so if he has one I always give a little lactelose.

Before he was weaned we had to use suppositoies and lactelose and make him to running it just came out.

I think the dismobility is due to him being constipated in the past, the muscles sreatch and become less effective.

We actually got to 5 mins before surgery when DS2 was 5 weeks old, only for him to do his first poo in 2 weeks and lose 5lb in the process

I am always here if you want a chat - Bear has my e-mail and address

oooh....he does eat banana.....lots!!!

that is the only thing he will opt for voluntarily, fruit!

otherwise, he fills up on yoghurts/biscuits/cereal/sweeties (at the mment as flamegirl here and poorly and we bribed calpol in with sweet's!!!)

oh, and icecream or ice lollies.

oooh....he does eat banana.....lots!!!

that is the only thing he will opt for voluntarily, fruit!

otherwise, he fills up on yoghurts/biscuits/cereal/sweeties (at the mment as flamegirl here and poorly and we bribed calpol in with sweet's!!!)

oh, and icecream or ice lollies.

Have you tried experimenting with different types of pasta? The health food shops sell pasta that's made of spinach etc, or brown pasta. Would he drink a fruit smoothie? (without the yogurt) Bananas do bung up I'm afraid. Especially when eaten with bread. Fruit's very good, especially the soft pears. Themadhouse knows what she's doing. They tend to give the little ones medication to sort this out without looking at the problems underneith. Baked beans are ok.

right....list of food eaten today.

breakfast.....cereal (rice crispies) with soya milk and a waffle with maple syrup. orange juice and apple juice

at the hospital....daddy bought chocolate and he shared my water.

lunch, we went to BK, he ate four popcorn chicken nuggets and several pack of tomato sauce (he dips in the nuggets and sucks off the sauce) and a bag of fruit plus a carton of orange juice.

got home and he had 2 bourbon biscuits.

flame got here and with the sweets bribe he ate two sweets.

he has now just eaten a tuna sandwich and a soya yoghurt and drank a caprisun. h, and had a cake bar too. (the others had pizza, he hates pizza, and he would normally opt for beans on toast {altho he never eats the toast so really just a bowl of beans}, but he wanted 'lunch' as he had 'dinner' at the hospital.

he is now off to beavers, so will have a bowl of cereal I expect on return, plus his drink of milk, before he goes to bed!

this is about normal.....he never finishes anything other than his bowls of cereal either!

pasta......I tried different ones when he was on a coeliac diet as the gluten free was horrid so he had tomato and spinich....he now assossiates (sp?) coloured pasta with his 'yacky' diet (his words).

OK - swop his ceral for a higher fibre one ie wheatbix, shredded wheat or porridge. The roughage will really help.

Any bread give brown or wholemeal - we never have white in the hhouse - you can get the hidden brown stuff.

Opt for juices that are made from pressed fruit not concentrate, as they still have fibre etc in.

Sugars are not all bad, in fact lactelose is a type of sugar the body (bowel) can not absorb, therefore, keeping the stool soft. Loads of liquid. Doesnt matter that it is not water IMHI

Offer a peice of fruit after each meal or make up a bowl in the fridge, to save peeling apples etc.

Other goodies are lentils (you said he likes saugages) try quorn sausage casarole made with any veg really and add red lentils as they are great for bowel funtion.

Also chickpeas and the like, you could do a mash with chickpeas and sweet potaoe.

Anyway I am not waffling

You can get wholemeal pasta aswell. TheMadHouse has some excellent advice. Give him lots of encouragement and praise when he goes to the loo, a sticker chart sometimes helps. It should get alot easier for him once things have settled down. There was some research into probiotics (eg Yakult), these are supposto help.

fruit is easy......he helps himself all the time

fruit juice, good advice re-fresh pressed...never thought of the added fibre.

bread....I am already buying the half and half type in the hope of getting them onto brown, then DH reckons I am cruel so goes and buys white again, and my work is broken again....(he has JUST done it again tonight and I am on a rage again about it!!!!!!!!!!!)

wholemeal pasta.....will try

anything mashed....he has an aversion to anything mashed and will throw up with the texture, I tried it with veg (he will not even touch any type of veg with a barge pole, and hiding it in pasta sauce/pizza made him stop eating spag bol and the like and pizza).

he likes curry sauces....any ideas on how I can addapt that...

sausages.....again, will try

cali.....tomato sauce he needs NO persuading with

erm.....anyhting else??

(we tried the point/sticker system last year, along with regular times for sitting on the toilet, what with the car accident etc, it got ignored. will try that again)

oh, and we give a probiotic each day...on 'actimils' at the moment

Ooh and tell these nice people what Flamechick was like as a baby cos I can't think clearly

hello psychomum, I used to work as a psychologist in paed services.. and like other people have said, they will want to meet with your ds and most probably you as a family.

They will want to hear what each of your views on the problem are, how you think it is affecting ds and the family as a whole, what you've tried so far and what of that has been helpful.. just get to know you and the problem, and how it all fits together.

Sometimes a psychologist will meet just with a child when it comes to these sort of fears, and with a little one like ds, will use play and drawings and things to help him communicate some of what he might be worried about.

Psychs in child services are usually really good at liaising with schools, some schools like an educational psych to do the developmental assessments, but in any case they should work together so you don't get disjointed messages about how to best help him..

In terms of your dh being unconvinced that a 5 yr old can have 'issues', yeah, I probably wouldn't use that term either, but it is normal and common for children to have fears, which they might not know how to talk about or to solve. And psychs can help with that.. Body stuff can be frightening for children too, because it is something internal and they sometimes therefore think they should be able to deal with it themselves and feel bad when they can't, and so it turns into a vicious cycle (if that makes sense). I've worked with lots of children who have had tummy problems, common I think because fears and digestive problems are so linked (physiologically, when you are stressed/anxious, your digestive system slows down, so if your ds has a sensitive tum anyway, feeling worried about something (like the car accident) might well trigger that off again). So, helping him feel less scared will contribute to a happier tum too..

oh, and in terms of waiting times... really depends on the service. Once you've had a referral and you know where it is to, it is worth phoning the admin staff and asking how long the list is, and how quickly it is moving..

hope that helps. Sorry for the length of it!

thanks lots for that spink.

makes me happy too to read that the ed psych and med psych will refer to each other (well, YKWIM), as I was thinking that either one or t'other will refuse to see us/him thinking the other will sort it out....to see that both will look at him is reassuring as I am guessing that they do do different jobs (even tho in my OP I was querying whether one could do the same job).

I am back to see the gastro team on 19th may, so can ask then where they have referred him to chase up.

OK - he likes curry then make a dahl type curry. I have a really nice and easy recipe, you could serve with wholemeal pitta pockets.

55g of red lentils
2 tablespoons of basmatti rice
half red pepper chopped
pinch ground cumin
pinch ground corriander
pinch mixed herbs
250 ml water
25g spinach
2 tablespoons of tinned toms

put rice, lentils, pepper, oiks and spices in a water and cook for 25 mins stir in spiniach and wilt. Serve

It is OK to freeze

Also curried cauliflower,you could even make a batter and coat and deep fry some veg, pre steam it and then in a really hot oil like tempura

Sweet potatoe chips

Hope this helps

glad to be of help psychomum! just to add, some med psychs would also do the dvptal assessments, depends on the service and the individual psychologist's skills..
hope it goes well with the team - good luck - and don't be afraid to ask for what you think is needed, as the parents you are the experts on your boy - you know him best.

ta for the recipe madhouse.....sounds nice lovely so even if he doesn;t eat it, then it will go down well with the others

spink....more thanks