Withholding / disimpaction / chronic constipation

[Mercier1]

I really hope someone can help us.

My son is 3 since feb. Over the winter we have moved house had a new baby and had a lot of stress at home. During this period my son woke up one day and said I want to wear pants so we followed his lead. He did really great with wee’s. He did one monster poo (like a tennis ball) that I can recall around this time and since the last four months I don’t recall a normal poo.

He is chronically constipated. 4 x GP visits. I’ve been trying a lot of things. 4 x Movicol, adding lactuose/senna and now something else as and when.

He does overflow liquid poos in his pants or nappy. (We’ve been going back and forth and following his lead on him wanting pants but he’s back in nappies this week) in the last ten days things have escalated and now he only poos in his sleep which I feel is the most depressing thing ever. The only time my child is relaxed enough to poo is asleep :-(

We have tried the apps, reward chart etc. Etc. We are now following the advise of Eric and disempacting him with 8 x doses a day. Except he’s still not going. I’ve done this for 2 days and tonight I have 10ML senna and nothing.

Does anyone have any experience like this. Is there light at the end of the tunnel? I feel this is having a huge impact on every family member now. Any advise or experience is great. Thanks

[AlphaMama]

Hi, my daughter is five and we've been dealing with chronic constipation for three years now (she's an extreme case, please don't panic).

I recently discovered a book - It's No Accident by Steve J Hodges. I cannot recommend it enough. Reading the book not only helped me (and those around us - grandparents, teachers, etc) understand what's going on so much more but also made me breathe a sigh of relief that we're not alone. I photocopied sections for the school and they were so grateful as well.

The other thing I'd say is the GPs are hopeless. They don't understand chronic constipation and the long term issues it can cause for a human in enough detail. Get yourself a referral to your local hospital to see a gastroenterologist. I had to really push and push to get this referral - my GP even called me a pushy parent to my face and said I was doing DD no favours, that "she'd get it in her own time". But when we finally started seeing the gastroenterologist last summer everything started to change.

Gastro. put her on x8 sachet of Movilcol a day and another type of medication that is a bowel stimulant (obviously this is what was right for my child - every case is unique so please don't suddenly up your son's dose on my advice!). It took four months of that medication for her to finally pass the impacted stool (as I said, we're an extreme case, please don't panic) and we're finally now into the maintenance stage as of just last week. So we're now slowly week by week reducing the Movicol and it'll be another six months before she's down to maybe one or two sachets a day.

Chronic constipation is a marathon, not a sprint. You won't see results (in our experience) over night and you have to be patient. If there's holding behaviour as a part of it, that also takes a long time for children to unlearn and relearn good habits.

Stay strong. You're far form alone. Reports are now suggesting that this affects up to 30% of children, but most of those are undiagnosed because it's not widely talked about.

Just get yourself a referral and stop relying on the GP :(

Good luck!

[starbrightnight]

Glad things are improving, OP. Don't forget that pre and probiotics added to his diet might ease things over the long term.

[roundligament]

I have to take 8 sachets of laxido (movicol) at the moment for my constipation as I have basically got stone sized poo stuck in my lower bit. I can feel it through my vagina.
Codeine did it.
I did 2 days of 3 sachets no action
2 days of 4 sachets small poo hard and some goop
1 day of 8 sachets lots of poo but not water
Finally went properly today which I would say was the poo but no water

The suppository just made me fart at that point

I am pregnant and weigh 52 kg at the moment
So if you think of it like that to see how your son might be

Baring in mind I had to go sit on the toilet and make an effort to go this morning this wasn't poo falling out of me

Before I had to have 3 days of 8 sachets and then still an enema in a&e when I was impacted
It was fucking awful

[Mercier1]

He used to poo in the bath but not anymore, only his sleep now. So tough. The disempacting is working but say 8 and still not water 😒 don’t think I’ll use the supps at this point but I’m adding in the stimulant lax as well at the moment.

[endofthelinefinally]

More fibre is ok as long as no stretching of the bowel and no impaction. Disastrous if either of those are present.

[roundligament]

Are you looking for glycerin suppositories
You don't need a prescription for kids ones they sell them beside the adult ones in my chemist

I use them all the time when I am
Constipated

Just wanted to send you some virtual support you sound like such a caring mum

Constipation is the worst xxx

Can you ask him to poo in the bath maybe ?

[Unusualllly]

Interesting about the high fibre food, my HV said more fibre and lots of water.
I feel like we are on a huge learning curve but every new bit if advice is so welcome.

Thank you everyone for inputting.
I hope Mercer things keep improving for your DS, getting them to drink more liquids and drink Movicol is much easier said than done. Good luck x

[Mercier1]

Ok thank you. I’ll keep going. He is being particularly defiant which isn’t helping. Sigh.

[endofthelinefinally]

Mercier1
If he is going every day, I would just keep going with the movicol.
Stimulant laxatives can cause awful tummy ache and cramping.
Encourage plenty of liquids, vegetable soup, fruit, stewed apple, tangerines, oranges, cooked carrots.
Do Not give high fibre things like bran or dried fruit - these cause solid blockages in the stretched bowel and make everything worse.

[NuzzleandScratch]

Hi, just wanted to add that we are/have been going through this since dd came out of nappies at 2, she's just turned 9, and sadly we still aren't out of the woods. Regarding the Movicol clear out, we've done this a couple of times & the whole process took about 10 days. It's important to ensure they're drinking plenty of water during this time, as the medication works by drawing water into the bowel. I wouldn't worry too much about a stimulant at the moment, this is something we restarted once we'd done the clear put. Personally I found sodium picosulfate made things explosive, so we use Senna now. The paed gastro we see said the mistake a lot of parents make is trying to come off the medication too soon, and for us, she recommended continuing the Movicol for at least a year after the clear out. Essentially when they've been impacted, everything becomes stretched, and it takes a while to shrink back to normal & regain normal sensation. I do sympathise, it's been a hugely stressful experience for us. Best of luck.

[Mercier1]

Why has someone reported my post about poo? Like seriously. This thread has been a real support to me...

[Mercier1]

Thanks a million, yup he’s playing the Tin whistle !!

[HepzibahHumbug]

Don't know the answer to yr last question OP but hope somebody does

Re relaxation on the toilet/potty ideas: believe it or not playing the recorder while sitting on the loo (trainer seat) really helped my Dd at the same age. The act of blowing relaxed her muscles and trying to play tunes took her mind off the job in hand.
I remember how stressed out I was about it. Awful!! But pps advice to stay completely calm and cheerful is really good.
Best of luck and onwards and upwards!

[Mercier1]

Hi guys I wanted to update and ask a question... it’s now day seven and we are still not at rusty water. I guess I need to add a stimulant laxative in, should this just be at bedtime?

[Unusualllly]

Thank you endoftheline, will try upping the Movicol.

[Unusualllly]

He is doing big poos, so the backlog of clearing which is great.

Routine toilet relaxation is a great idea, for us that will mean cbeebies on the iPad. Worth a try though.

[endofthelinefinally]

Unusualllly - you probably need to increase the movicol so he goes every day.
Have you watched the Poo nurses video? They explain it really well.

Mercier1 - it sounds like you are doing really well. Whatever you do, don't stop or reduce the movicol too soon. That is the most common mistake and it takes everything back to square one. You have got 4 months of back up to shift, then the bowel has to be completely retrained and it takes a long time for the damage to settle and for the overstretched bowel to shrink back. You are looking at a minimum of 8 months of movicol, probably a lot longer.

[Mercier1]

Hi guys I was thinking of updating and then felt weird as who else cares but these last few comments cheered me up. Well we had a massive shit the bed on sat night, thought that was it to be honest and we kept up the protocol because still wasn’t watery. It actually seemed to be going watery yesterday and I called ERIC today and she said some great advise. She said sometimes the blockages are in pockets and so to carry on for about three watery poos she said they would be like rusty water.... well today he held it in ALL day and then at 5pm exploded again.
Poo pouring down his legs into his only shoes 🤯 I was shocked it was still number 7 not watery... he must be SO backed up.

Other advise for breaking the withholding cycle as mentioned above was getting a really strict and regular toilet routein, encouraging relaxation on the loo, don’t encourage pushing because they don’t know how too. Hope This will help others. She also said a bit of senna might speed the process up. I didn’t do that tonight but I might tomorrow as that will be day five...

[Unusualllly]

Just wanted to say, you are doing great.
We don't have poo in sleep or impaction (I don't think?). However we have been on 2 sachets Movicol a day for 7 months, DD poo dances all day, crossed legs, tenses up, skid marks in pants then after a few days eventually does a big soft poo. How the heck you break the cycle I do not know.

It horrible seeing your children like this, this thread is offering lovely support, thank you.

I hope your son improves after his poop explosion.

[Rolypolybabies]

How is it going?

[Mercier1]

Thanks everyone (insert poo emoji)

[endofthelinefinally]

Take it slowly.
Get the impaction cleared then review the nappies/ pullups.
Good that the clear out is happening.

[Rolypolybabies]

Good luck tonight

[Mercier1]

OK so he’s just completly exploded all over the bed, start of disempaction I think. It’s going to be a long night :-/

Re the sitting I pad etc. He currently Refuses to sit even for chocolate which is like crack to him, tried poo goes to Pooland, dr ranj, sitting with a friend etc etc and won’t go. This all coincided with potty training (instigated by him/ woke up said I want to wear pants) so he was never fully trained etc. We’ve stopped that this week but he’s keen to wear pants and ERIC advise is once you go into pants don’t go back...