DD 3yo withholding poo - no doctors appt till 27th

[Thesunrising]

DD, 3 next month, has always had a slow digestive system, pooing every 2-3 days, but this has become much worse in the last couple of months and the duration between bowel movements is becoming longer 3-5 days and DD is getting distressed and is in pain when it finally happens. Poos come out very hard and large. Today after 5 days with no poo, DD telling me that her wee is hot too. :-( and has been dancing round on her tip toes all afternoon trying to avoid going to the toilet.

I don't think her diet is a problem - it's varied and she has plenty of water, fruit, vegetables etc. I've done poo goes to pooland, tried bribery, sticker charts, I'm running out of ideas. We were at the gp a couple of weeks ago with an unrelated cold/virus and they tested her for a possible UTI which came back clear.

I've got an appt with the GP now for the 27th, but I'm wondering what I can do before then to relieve the immediate issue. Is it possible to get anything over the counter thats going to clear the build-up - can I get glycerin suppositories or any other kind of laxative? thanks

You can use suppositories but the over the counter ones are usually only adult dose.

Have you tried regular prune juice or boots do a fig syrup for constipation that's suitable for kids. Both work in the same way as lactulose, by increasing the sugar in the gut it increase water within the gut softening stool.

So, prune juice, or fig syrup, warm/hot bath, and maybe order some kids glycerin supps. And make sure her feet are supported and knees up on the toilet.

Hope she feels better soon.

Thanks. will get the fig syrup tomorow - getting her to take it will be another challenge! With regard to the glycerin supps bought online - I saw these advertised in several online shops but was a bit nervous about getting them without gp advice. Are they ok to use as a one-off, emergency measure?

We had a nightmare with DS1 doing this (he's 3.3) and the doctor prescribed movicol.
I'd recommend prune juice over the fig stuff as it took a good couple of doses before the fig stuff worked.

I'd also suggest putting a load of Vaseline on/around/just inside her bottom so it doesn't hurt as much.
FWIW I thought DS1 would never get past this and certainly not be potty trained for a long time but after the movicol he realised it was ok, has just asked to ditch the nappies and has been dry/pooing in the potty or toilet for nearly a week now! Hurrah!
Good luck!

Try fig roll biscuits if not. My two love them.

You could always speak to a pharmacist for advice about the suppositories.

Prune juice is great. Actually really sweet so most kids like it. Maybe get both and see which she prefers followed by obligatory chocolate button

Thanks everyone. I will try everything!

we had this - we had to get paediatric movicol and go with three sachets a day for about a week to clear the impacted poo and now she has one sachet every day to keep her poo soft. You can buy it over the counter from pharmacies - it's not like other laxatives in terms of being 'bad' for the bowel. we mix my DD's sachet in with her morning hot chocolate.

You can get it on prescription as well, obviously, but just thinking you don't ant to leave it until 27th to sort out impacted poo!

Paediatric Movicol is the answer - up the sachets until poo is gravy consistency and can't be withheld and then don't be tempted to stop when she starts going as she'll need it daily for months for her bowel to return to normal and her to learn how to go and not to be scared that it hurts.

Doesn't your surgery have a batch of the same day appointments they release each morning? Tell them it's fir a 3 year old. We've been with 2 surgeries since I had DD and the always accommodated her the same day, even if it meant an emergency appt.

We have had this too, for the first few attempts at the GP we got given lactulose and got told to keep increasing the dose and for some children this does the trick (softens the poo so it hurts less) eventually we got given movicol and this seems to be working, regular poo every other day or so with no crying

My DS is on Movicol. It's a stool softener, not a laxative as such, and has worked really well. However, you shouldn't attempt a "clear out" with increasing doses without consulting your GP first.

Kiwi.

But I think you need to go to a walk in if your doc can't help

DGS had the same trouble. Lactulose and sitting on comfy seat with feet supported whilst he blew bubbles all helped . But I am sure that my poo dance with waving my bottom helped
. " come out and see me some time-time. Come out and see me some time-time. I will take you for a swim in my little toilet. Come out and see me some time !"
All delivered in rapper style !
Good luck it's so miserable for them ( and you ).

Severe constipation is a very real emergency. I used to work in a gastro Ward and we'd regularly have people admitted with constipation as their sole complaint. Also, a clear uti screen two weeks ago is no indication that she doesn't have a uti now.

I think you need to go to an out of hours appointment and get her something.

Look on the ERIC website for information and advice.
Movicol and lactulose are good.
DON'T give high roughage food like weetabix/wholemeal bread/dried fruit/bran because this makes the problem much worse by making large solid stools that are difficult to pass.
IME pharmacisits won't sell you paediatric glycerin suppositories, but you can buy the adult ones and cut them in half.

However, before you do that I would ask for an emergency/on the day appointment because you don't know if there is anything more going on here.

Chronic constipation/impaction/witholding is a long term problem and there are no quick fixes. You usually have to treat/manage for at least twice as long as the problem has existed, which can be months or years.

Could never get dd to drink the movicol. She would have the fig syrup though. I found a piece of chocolate would also help (caffeine I guess?) I spent a good few months cuddling her whilst she sat and cried on the loo with one hand on her tummy (which used to make her go). The stinging sensation in the urethra is exactly the same as I get when I am constipated. I don't know why it happens but I would imagine that is what she is experiencing. I hope you are through it soon. Poor mite :(

Thanks for the further advice. Just got back from pharmacist who sold me lactulose though he said this wouldn't have any immediate results. Movicol not mentioned. I've managed to get a dose into her mixed in with some apple juice. She has now done a poo, but I don't think it was all of it. If that hasn't paved the way for more to come out then ill head to the out of hours tomorrow. I'll still keep the appt on the 27th to get some advice for long term management.

Don't confused into thinking that when she's done a poo she isn't constipated any more - it sounds like the problem has been brewing for many months and as 3littlefrogs says you need to treat for at least twice as long as it took to develop. The ERIC site is brilliant for advice.

Lactulose is very mild. Pharmacist is unlikely to be a paediatric constipation expert so probably wouldn't have sold you the movicol unless you mentioned it. It may help but generally movicol tends to be the best long term option.

If I go to a different chemist this afternoon and ask for Movicol for a three yr old will they be able to give it too me without a prescription?

Ds 3.8 is a witholder and has been for a year now.

Lactulose and suppositories didn't help and he reached day 14 after 4 movicol sachets he finally went.

To get him to go we have to keep it soft (if we don't it'll go harder and 'the fear' returns) so a sachet a day or an extra one for each day he doesn't poo and when he starts withholding I overload him with water/juice and eventually it just comes.

I would definitely push for the gp to get you in sooner, it's a horrible thing for a child to go through

I know I'm not a child but I have been constipated ALL my life and tried every single laxative in the world . Movicol is the only one that works , it changed my life. It is gentle and very effective. Does not give stomach cramps or that uncontrollable urge to go, just a gentle feeling , not traumatic.

Hope this helps x

3littlefrogs, tell me about it. We have been battling DS's poo issues for nearly a year - the constipation has led to an overstretched colon/rectum with corresponding loss of sensation = constant soiling. We are deep into the joys of bisacodyl suppositories

I'm pregnant and a bit constipated at the mo so have been drinking prune juice diluted with water. My 2 year old asked for a sip so I gave her some and she went on to do 2 enormous poos in the toilet followed by one more that came in her pants too quickly before she could get to the loo on time. Prune juice works!

My DD is just the same, lactulose has been useless, Movicol is the only thing that has worked. You have to use it long term, I now give DD a sachet every other day and have done for months, to keep it at bay.
I am appalled that you have to wait over 2 weeks for a GP appointment for a 3yo! I would be calling every day hour to nag for an appointment. If your DD is saying her wee is hot she may well now have a UTI (common with constipation as it can stop the bladder being fully emptied) which certainly shouldn't wait that long to be treated.