My 6 year old will not poo!

[TommyKnocker]

For a few years now DS6 has been awkward about pooing. Used to say he didn't need to go when he clearly did/with holding. Lots of shouting and crying, over the last year though he got so much better. Still only pooping twice a week (doctor not concerned) on particular days, being directed to but it was getting better.

Last month and it has all nose dived. Lots of screaming and shouting, refusal to sit on the toilet. When he does go, only little amounts of poo.

He's currently sat on the toilet after loads of screaming and dh is reading to him. He's been there for an hour.

Been back and forth to the doctor, given lactulose and another softener. But I don't think the doctor gets He's not constipated (well he might be now), he is deliberately holding it in. The softeners never really seem to do anything even at high doses, they make him bloated and gassy though.

Diet is good, fruit, veg, as many nuts as I can make him eat. I have been trying different juices.

Any suggestions? The doctor was happy with twice a week as he said that appears to just be his level but now I'm struggling to make him do two. I'm going to try and get an appointment for tomorrow, but has anyone had simialr?

Who is doing the screaming and shouting, and why? I see ERIC advised a lot, they may have something of use...https://eric.org.uk/

Thanks, I'll check out that link.

It's ds doing the screaming and shouting, dh and I mange to remain calm although we do tag team.

Get him off the toilet. An hour of being upset won't do any good and won't help for the next time.

You need picosulphate which is a stimulant laxative.
He needs to drink plenty water
Take all pressure off now. Tell him you expect him to do 10 mins "sitting time" every evening but that you won't mention pooping at all.
Don't show any anger or annoyance. Just put the lactulose into a drink. Give a 2.5ml-5ml dose of Pico every day. It will come without you having to talk about it.

My 3.5yr old is currently doing his sitting time but he's managed a poo every day this week so far.
We sometimes offer rewards such as little toys I've picked up for a quid or a sweetie or something so the whole experience is positive.

There's a book called "it hurts when I poo" of deffo get that. It has a really good analogy in it that your 6 yr old will understand and there's also tips/routine to follow at the end of the book.

Also it sounds like a bout of constipation has triggered the witholding again. If it was sore then he will be scared the next poo will be sore so you need to ensure the next lot are soft and not sore.
Ice lollies, fruit shoots, whatever just to entice them to drink more!

Get him to blow up a balloon whilst sitting on the loo, this can really help.

It's likely to be that a poo hurt so he held it in, making it harder and so then hurt more. This will have caused constipation. Ends up a vicious circle. My DS had the same aged 2. We tried all things diet related and lactulose, syrup of figs etc. The only thing to work is movicol. One sachet per day. He's still on it aged 3.5 as if we come off it his poo looks hard and cracked again and we don't want to go back to how things were. Movicol draws water from the bowel itself so is kinder to the body than other softeners.

Yy to movicol. You can give them a fair bit of that, starting with one dose and increasing daily until a full clear out.

@Hungrycaterpillarsmummy he hasn't been on the toilet for an hour, I meant an hour trying. So on and off, then a warm bath for a bit.

I'll try and get some movical tomorrow.

I think part of the issue is he really doesn't need to go every day, even as a toddler before this started he probably went a max of 4 times a week. But that means if he does, for whatever reason, miss a poo or do a small once it's so much worse.

@HumphreyCobblers I'll see if I can find a balloon, we've tried bubbles before which is probably a similar effect but I'll try anything at this point.

We had this with my 3 year old, it's was awful!! Nothing helped until we used movicol. It was all triggered by a painful bowel motion which made him hold it in therefore causing constipation so it was a vicious cycle. It took a lot of movicol to get things moving properly but once he HAD to go (obviously he couldn't hold it anymore with all the movicol) and it was looser and no longer painful, he got over his fear within a couple of weeks. I was so relieved, it was an absolute nightmare and so heartbreaking to see him so distressed. He's absolutely fine now and goes no problem.

I imagine his bowel is stretched. My son can withold for ten days so after he does do a poo be doesn't feel the need for a long time after as his bowel is so big. Its going to take years to shrink down again.
I imagine this is also why your son is going only 2-4 times a week.
I look back and see now this all started when my son was a baby and he didn't poo even as a breastfed baby. He definitely was constipated and I just didn't realise it so that was a bad starting point as his bowel must've really been stretched then :(

I think you're going to need Pico a long with movicol/laxido. Just for a wee while at least

@Hungrycaterpillarsmummy yes, didn't know the bowels could be stretched but that sounds exactly right.

Stretched bowels can be cured but it takes time. You have to do a disimpaction regime using increasing movicol dose (up to twelve) until they are basically pooing water with bits in. Then keep up the movicol with a higher dose to ensure emptying daily and the bowel will shrink, given enough time. This has worked well for my son but we had issues for years until given proper advice from the bowel clinic.