3YP constipation/viscious circle

[Bunny2607]

Hi everyone

edited to say sorry title should say “3YO constipation/viscious circle”

sorry if this is long but i feel i’ve got myself in such a mess with my DD (3.5yrs) without realising and not sure how to put it right.
she had her 3 year vaccinations about 2/3 months ago. Before then, she was toilet trained and in knickers everyday, she had poo accidents more often than not and we used to say to her we can’t do poo’s in our knickers we do them on the toilet or the potty, and when she did do them on the toilet etc she got bundles of praise and treats/toys as i was trying to encourage it. All in all she wasn’t perfect but i was ok with it given her age and nursery reassured me poos take longer for them to get etc and to persevere with knickers so as not to confuse her.

she then had the vaccinations, and since then just isn’t pooing properly. She regularly complains of stomach ache, i’ve had her to the GP several times and they can’t feel anything wrong and say her tummy is soft etc. the gp gave her laxatives as he thinks she is constipated, she isn’t pooing much, she will do like 4/5 skid mark poos and she also started asking for a nappy on to do a poo so i gave in as i thought if she poos great, but she didn’t always do one or would go the other way and do 4/5 small poos in the nappy. Its got to the point recently where she is basically back to being in a nappy so yesterday i have said no more nappies during the daytime as i’m massively going backwards with her.

i just don’t know what to do. I’m scared to give her the laxatives as someone told me the body becomes used to them and forgets how to poo on its own so it will cure one problem and replace with another. How do i sort the poo problem out? Sorry if the post is garbled i feel like i can’t see the wood for the trees right now with it 😫 it could be a huge coincidence but i just feel its all come on since the bloody vaccinations, she’s so different.

Tried seriously upping the fruit? Prune juice mixed into other things (into a smoothie for example)? Used to be a surefire way to get mine to poop. Also, the last 2/3 months it’s been pretty hot - could she be dehydrated? That can make the mucus membrane down there dry out and harder to pass stool. Particularly if you’re hanging onto it a bit too long.

As to the mechanics, have you ruled out it’s not nipping/hurting her when she sits on the potty or toilet? Cos everything will be a bit more ‘spread’.

You need to give her the laxatives! She sounds quite badly constipated and every time shes forced to pass a hard poo, she'll become more wary and hold on to avoid the pain. Proper laxatives until she is passing liquid will help all the old poo come out and then yoi can start will soft poos and retrain her to use the toilet.

Was it laxatives or stool softners (movicol)? Stool softners don’t make you need to poo but keep water in the poo so they don’t become dried out and sore to pass.

Have a look on the ERIC website.

I had a DC with chronic constipation. Water is everything. As much as you can get into her. Not juice. Give her lactose solution. It doesn't enter the bloodstream. It draws water into the bowel creating soft, bulky stools that are easy to pass. Movicol works in a similar way.

Does she have a lot of dairy? I’d cut it all out it makes such a difference well it did for us anyway.

When a child has become properly constipated, the hard logs of poo sitting in the rectum stretch it up. You then have a big baggy rectum full of hard stool, with softer poo from higher up the gut leaking past and causing accidents. In order to regain continence, you need to give shedloads of movicol/laxido to clear all the backlog, and then continue a lower dose for months, so they’re passing soft squidgy poo every day, so that the rectum shrinks back down and heals up. If you don’t give the laxatives, they can’t get better. And the myth about getting dependent upon laxatives comes from the totally different stimulant laxatives in the very elderly. Have a look at www.eric.org.uk then please restart the laxatives.

Do not withhold laxatives, kids storing poo in wrong place end up with baggy rectum and no sensation or control. We fucked it up when my daughter was 3 and it took us til she was 12 to fix the issues. Daily soft poos are the goal. Gut most active 20 mins after eating so toilet or potty sit then. Ensure her feet are supprted and her knees higher than waist to get optimum pooing position. DO NOT WITHOLD LAXATIVES

I am sitting in tears tonight coming on to post about my son because I’m in the exact same situation and have been since he was first potty trained almost 2 years ago. The most helpful (only helpful) advice I’ve had was from the ERIC helpline. They have time to listen to the whole situation and really do help. It sounds pretty much the same (minus the vaccinations part). I was advised to do a disimpaction routine with the laxido so up the dose each day over the course of a week to properly clear him out then start from scratch. They hold it in and over time it stretches the bowel. There’s then a blockage there and as new softer poo arrives it has nowhere to go and escapes round about the blockage, hence the tiny accident each time. We did the whole disimpaction thing though but we’re now back there again and I’m upping the daily dose he takes but it’s just making the daily accidents more severe so I think I need to go all the way through the disimpaction thing again. The problem is they pretty much need a week off nursery to do it as they have less control than normal.

My son’s number one issue is just stubbornness and I just feel trapped in this never ending cycle of dirty pants being binned. I have to pretty much drag him to the toilet and tell him when to go every time. It’s honestly soul destroying. It’s drained every ounce of life out me over the last year and a half 😭 particularly when we go to a kids party or something and I realise that all the other kids just go to the toilet and I’m constantly on edge waiting to see that his pants (or worse, trousers) are dirty 😩 I love him dearly but I genuinely can’t take much more of it

You need to spend some time on the ERIC website. Not reading random people’s comments on laxatives.

However, as a random person with a child with a food allergy that causes constipation…..

The laxatives are almost certainly osmotic laxatives. They don’t change how the bowel works. They make the poo softer and bulkier and easier to pass. A few weeks of that will get bowel content back to normal and can then gradually wind the dose down. Lots of fruit. Lots of water. Less dairy.

All of the above (minus the dependency comments). However in my experience this is a very long process. It’s not a ‘movicol until the poo comes out’, it’s months of treatment. ERIC suggest that you need to continue until they poo rusty coloured water, even if you feel you’ve now overdone it. With my own DC I resorted to glycerin suppositories as the backup of poo got so ridiculous. It’s not comfortable to administer but that cleared the initial blockage fully and then movicol was there for the ongoing management. If you’re going to go down that route, speak to GP on how to do it in the most comfortable way.

Thanks everyone for your replies they are all really helpful. I will start on the laxatives and use them as prescribed. She was initially given movicol (i think - we are away from home so I can’t check, they were like a sachet of powder i used to hide in juice) and then given lactulose. I will admit i haven’t used them consistently or as i should because i’ve been worried her body is going to forget how to poo on it’s own but i will have a look at the ERIC website i’d not even heard of that before.
re dairy, she did have a dairy allergy as a baby and was on prescription formula but we managed to do the milk ladder and she is ok now, but i will look at limiting dairy and see if it helps.
i think i’ve been so focused on not putting her back in nappies as i feel its a step backwards but maybe i should relax about this for now and sort the constipation out first. The dr has told me she isn’t impacted but it makes sense what you say about the hard poo and then fresh soft poo leaking out, it explains all the tiny accidents each day. She never seems to do a substantial poo, she will do a slightly bigger one but the consistency is strange almost like cement- is this a sign of constipation too?

honestly i just feel overwhelmed with my daughter, she’s got so many little niggly things going on atm it just feels like one thing after another for her 😢😢

It sounds like she might have 'overflow', where a hard stool is causing a blockage but softer poo/diarrhoea is getting around it and leaking out. Movicol (multiple sachets) will help to break down any hard lumps and she should be able to pass them. You must be totally consistent with the laxatives and lots of water. A one-off "good" poo is just the start. She needs to have many pain-free bowel movements for her to understand that it isn't painful any more. It will probably take months but don't worry - these laxatives don't enter the bloodstream stream so won't affect her in any other way.

Thank you. We have just got home and i have given her some, and will carry on doing now. I was just abit wary of the laxatives she seems so small at 3 and i’m worried about what i’m putting in her system but it seems to be abit of a trust the process thing. She is good at water drinking and eats lots of fruit so we will try increase this as well and hopefully it will help. Does anyone know how long it takes for the movicol sachets to start working? Should i just stick with movicol as we have been given lactulose as well? Thanks

Sounds like she was constipated before the vaccinations, the poop accidents are a classic sign of constipation.

Make sure you mix the sachets with the water before you mix it with any squash (the powder "inflates" the water molecules so it's not absorbed by the gut and can be absorbed by the poop) movicol doesn't make the bowel lazy it allows the poop to get soft and clear out then the bowel shrinks down after it's been stretched by the hard poop.

it can take a few days for the poop to start moving. I would be very tempted to make sure she's completely clear of poop this means doing a disimpactation regime where you are aiming for muddy water....but you need to be at home for this! Look at the disimpactation regime on Eric website.

stick with movicol and if it's not working after a week then you can start thinking about lactulose

My DC was even younger (2) when started on lactulose and senna syrup to stimulate the gut, both prescribed by a consultant. She will be absolutely fine.

@Bunny2607 movicol takes about 24h to stimulate the bowel movement

Oh crumbs i’ve just put the movicol sachet in a smoothie, will it not have worked? It was one of the aldi 4 packs with the straw, they are 150ml and she drunk it all with the movicol in so will this do anything do you think?

i’ve read the box and it says mix in 62.5mls of water which i will do from now on before i put juice in 🙈🙈

@Bunny2607 ah never mind! It won't work unfortunately. I would just make up another sachet and add it to a cup of water or dilute squash. You will probably need more than 1 or 2 a day to get things properly moving.

I thought i was doing so well lol. Right i’m off to make her another one now and then will aim for 2 tomorrow.

thank you everyone for the replies i really appreciate it 😊

Don't worry too much you are doing fine! It's a really common mistake to make at least you know now! It can be added to pretty much anything once it's been mixed with the required water, although I don't think milk is recommended as it curdles. It can taste a bit salty especially if you are having several together. It also supposed to taste better cold.

I or 2 is a maintance dose for when you get things under control.

Ok thanks guys. So i’ve just measured out 62,5mls of water and mixed the sachet in and then put a drop of dilute orange in. Is this right? I then had to syringe the whole drink into my daughter as she wasn’t cooperative, i feel bad but in a cruel to be kind situation here i guess.
i did ring the GP this morning to check the dose and they said 1 sachet a day and it also says that on the box but do you seem to think it should be more? Thanks again

Just trying to put DD to bed and she’s complaining of tummy ache 😢😢

@Bunny2607 what does she usually drink? just add it to that.
once you have the 62.5ml solution you could add it to her bottle of water, or the smoothie anything that she normally drinks.

she Might experience a bit of discomfort as it starts to work as the bowel starts moving, at this stage though it's likely to be the constipation causing her pain

The movicol will be making the poo in her bowel swell up a bit.

Some tummy massage, some bicycle legs, and maybe trying a poo may help.

Think weetabix when you put it in milk. It soaks it up and gets bigger and softer. That’s what movicol does to poo.

Get on ERIC and learn all about poo, and stool charts. Cement like is not a good texture.