Potty Training and Chronic Constipation

[TinkerBellesMumandFiFi2]

I need some help!

Tink has been going to the toilet, removing wet nappies etc for about 18 months. I've been trying to gradually move her into pants but it's been hard as if she is wearing anything she trusts it and wets herself. I decided this week we would just swap over to pants and hope that she learned she couldn't rely on them.

She has got better this week, although not quite there, however she has chronic constipation and takes Movicol for it, currently it's not having much effect and she's passing bricks which take a long time to come and then are followed by quite a few afterwards for a day or so. Every time she feels one coming (starts a day in advance) she panics, relaxes for it and wees herself! Although nappyless she will go to the toilet or potty for it.

I'm just not sure what to do now. We go away next weekend and I'm wondering if it would be worth stopping until we get back but either way how do we get past these two problems, relying on what she's wearing to catch her wee and the chronic constipation?

get the constipation issues sorted first as if you strain your going to wee at smae time nothing you can do about that

just stay relaxed and get her to drink plenty of water to keep stools softer and just keep trying eventually you will get there

how old is she? i would go with instinct if she's not ready then stop for a while and try again

when we trained ds we stayed at home with nothing on bottom half just got him used to going to potty or toilet when needing to go when he had mastered that we then added a layer make sure bottoms area always loose enough and dont wait for her to go to toilet ask every 30 mins or so and take her and when out at every toilet go in and seeif she can go

found it handy to have fold up potty under pushchair more convenient if quickly needing to go again i asked him every 15 mins when out

eventually as he got used to it he was able to control his bladder

but she may not be entirely ready at the moment so jsut go with instinct

She's 2y 9m.

The constipation isn't going to get sorted, she has chronic constipation which can be traced back to her mec. She is on daily medication just to make her go, it doesn't even stop her being constipated. She drinks a lot because of it and we watch her diet, after this long it's a way of life.

She has led the way in potty training. She has been going of her own accord since just after her first birthday, I put off trying to get her into pants because I thought it was a little young. At home she has been left bottomless for about a year in the day if we're not going out and very rarely has an accident. But put her in a nappy, pants or commando (we've had to a couple of times when she starts to pooh she will take several nappies quickly) and she will trust what she's wearing.

We're asking about every 20 minutes or when we go and she will tell us each time she knows she has to tell "Mummy or Grandad or Daddy or Nanny" (can you tell who's around her most?) but then two minutes later shout up "I've weed" or her favourite "I've dribbled!"

oh bless her i would continue then she seems to be doing well and the constipation is obviously something that will continue so eventually she will be more in tune with her body my ds did well from just after 2 we had few times we've had to revert back to nappies and just after his 3rd b day we took him to pre school in pants and he came out completely dry and stayed dry

someone else on here said start before 3 potty training forever start at 3 your trained within a week

seemed to be true in my ds case as he was dry to a certain extent but after he turned 3 he was dry completely

just keep doing what your doing and with patience she will get there

just remember older children still have accidents so she is doing so well considering her constipation problems also

my ds is nearly 4 and will still have odd accident not very often but do still happen

How much movicol is she on?
Are you absolutely positive she is not stool-withholding?
If movicol is not shifting, you can increase the dose.
When DS is impacted, it takes around 3 days of 4 or 5 sachets a day to get things moving.

She has one a day, if she hasn't had it for awhile we get explosions but then it settles down. She passes adult sized poohs and last time I cleaned her up she was badly bruised from it. I've noticed that if she is going to the potty that she does them more often and they're not as bad. She is a very clean child and does get very stressed over her poohs, to the extent that I have to make a joke out of her having wind because it freaks her out. I think if she is holding on it is because she knows it is going to hurt, it goes right back to the mec and possibly to do with her prematurity so it's more than just her worry.

You have my sympathies - constipation/stool-witholding is bloody murder.
They make is all worse for themselves.
Is your GP helpful?
I'm pretty sure that the only treatment is to keep on enough movicol to keep stools soft (and this means really really soft so that they can't hold them in) and then ignore ignore ignore.
Eventually, they will overcome unless there is a physical reason for it.
Even when things have settled down, the laxatives should be continued for some months (well it depends on how long it's gone on for)
My 39mo is going through this just now. Has had it since about 6mo on and off until it became constant at around 24months.
He is definitely improving but if I ever make the mistake of thinking he's over it and stopping the laxatives, we are back at square one in a day or so.

Do you mean she has one pooh a day or one movicol?
If it's one movicol, that's really a very small dose. When things are going well here, we're on 1.5 - 2.
Very clean child adds up as it's literally anal retention

By the way I think it's medical name is 'retentive encopresis'

One sachet, it helps at the start then it's not so effective. She sees the hospital - it got mentioned when she was in for her asthma and they've taken it up - and is due to go in soon so I'm going to bring it up again. She poohs probably once a week. She has about 24 hours warning for what I call the plug then she has about 24 hours where they get smaller and softer until it's just squish and then it stops again.

I was going to say that (anally retentive) in my last post. I've been joking since probably before she was one that she has OCD, she likes things right, she remembers how everything was before she goes to bed and it must still be like that (her dad gives us sleepless nights when he gets in with her when he puts her down and she freaks out at 3am because he's not there!) she started taking her wet nappies off and giving them to me before she could walk, if she wees on the floor she used to get a nappy (we used to use cloth but not whilst we've been at my parents house) and clean up without me saying anything... I could go on forever!

As I said though she was premature and the doctors have said it goes back to her meconium, apparantely what happens with that sets them up for life. While I do think she holds on I think it's because she knows what's coming. They're like something an adult would pass and very heavy (I flooded the bathroom last week when I wasn't careful dropping one in the toilet ).

It's crazy, she obviously wants to be out of nappies and has for a long time but then she's so scared of her BM that it's putting her back but then when she goes to the potty she does a lot better with them.

Somehow I need her to realise that if she does them in the potty life will be a lot easier for her! I'm just hoping when we move to our new place things will get easier because I won't be worried about putting a potty in the living room or leaving her naked all day (Mum freaks about it!) and being in our own home should make life more settled.

Oh dear - it's pooh hell!
If it's any conslation, DS is much much better now than he was at that age. My GP has told me that they always always grow out of it but there's no way to tell when.
No amount of persuasion makes any difference for us - when its going well, there doesn't seem to be any real reason for it. He started nursery 2 weeks ago and this firstly made everything a lot worse but he seems to be improving again. It's two steps forward and one back but it will get better.

I read a book by a paediatrician who specialises in this kind of thing - will see if I can find a link. I found it reassuring and informative.

I still think her movicol dose sounds really low - have you ever tried upping it to make them really soft? If her colon has been stretched it could take a long time of loose stools before it recovers.

www.amazon.co.uk/Constipation-Withholding-Your-Child-Soiling/dp/1843104911

consolation

I agree that it sounds like her movicol dose is too low. She shouldn't be passing "bricks" on movicol if the dose is right, the whole point of it is to soften her stools to make them easier to pass. Usually for chronic constipation doctors advocate a "clearout" using a high dose (anything up to 8 sachets in one day) over a couple of days, followed by a lower maintenance dose for the following weeks/months.

She will clear out on one sachet but if we keep going on one it's like she gets used to it. Stop it for awhile (which happened when she went to live with my parents because they hadn't got into a routine with it) then restart and one will clear her out again.

I'm going to bring it up with the hospital because we can't carry on like this and that bruise upset me the other day

In the meantime, any suggestions for potty training? She doesn't want to be in nappies and doesn't want to wee her pants (although she covers by saying it's funny ) but she panics too much over her pooh and forgets to tell us.

So if one sachet clears her out and you keep giving her one sachet a day then she gets impacted again?
I would just up it definitely.

Every time she gets impacted and then clears out, you're back to square one. The aim (I think) is to get one soft poo a day using as much movicol as is needed to achieve this. This is the only way to break the cycle.

Also, with her getting impacted all the time, her colon is never recovering.

Sorry if I'm sounding bossy but it's a subject really close to my heart and I know how heartbreaking it is. We don't want to give our kids medication but it really is necessary in this case. Missing doses or not using enough just sets you back further every time.

Movicol is a far preferable option than senna or picolax (or whatever it's called) which can really irritate. It's inert so isn't even absorbed.

Oh sorry - missed the potty training question.

I delayed and delayed potty training as we had a lot of overflow soiling and I knew so many pants would end up in the bin but in the end it was getting ridiculous - he had been ready for the wee-wee side for many months.

Finally at just turned 3 I plucked up the courage and it was a breeze. I had to put nappy liners in his pants, or just chuck them if they were uncleanable as obviously the poo problem was still there. I would go for it - it prob won't make a blind bit of difference but if she hates wee-ing in her nappy then sounds like she needs it.

We've given up on pants and put a potty in the living room. She is going most of the time now, asks to have pants on (and even uses it when she has a nappy on, she still sleeps in one) and seems to be pooing better!

Bless her, she will let anyone empty out a wee but when she has pooed she points to the sofa and says "you stay there", carries the potty upstairs, empties it out, puts it in the sink, fills it with water and tips that down the toilet! If she has an accident she has to clean it up. Do you think this might last till she's a teenager? Maybe I'm asking too much!