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

Hey thanks for re reading. Pressing on. Yes I agree. There’s been a huge amount of stress in our lives (discussions of breaking up even) so it’s been hard to communicate about this issue; or any. My husband gives the child breakfast most mornings and I would say has forgotten to give it 50% of times but now he’s woken up to it hes ok the same page as me. I agree it’s psychological but what can I do? I asked the GP and HV for support with that aspect for my child and they hadn’t a cluse. I’d pay to see someone privately if I needed but don’t know where to start even

Never heard of this I’ll research and thank you

Ok this is what I needed to read thank you

Keep on keeping on at this dose, Mercier - until it's water, not sludge. And I'm so sorry, sounds like a really stressful time for you.

I'd agree on the inulin, by the way - really good for microbiota, which may well have changed during the impaction.

Ok great. He’s now refusing the drinks so I’m beyond bloody stressed. Will get probiotics etc thank you.

We had this with DS2 from the age of 3. It started because he didn’t poo for a few days after being unwell, and the poo he eventually did hurt him.

We tried everything and ended up seeing a paediatric gastroenterologist. He sorted DS by prescribing Pico Liquid, after trying large doses of Dulcolax. I think there is a dose based on body weight for under 4’s. We used to call it liquid dynamite as it was so effective.

Can you make ice lollies, jelly, soup. Anything water based can have movicol in it.
There are other disimpaction regimens that were used years ago before movicol came along. I seem to remember small amounts of 3 different medicines that could be syringed in and followed by chocolate buttons.

He’s just fallen asleeep, he must be so tired and wrecked from this whole thing. As am I! Doc prescribed sodium picosulphate is that the same as ducolax as well?

Yes. Children with impaction are usually very tired, in chronic pain and very anxious all the time. Even if they can't comprehend or verbalise it.

I am quite depressed I hate seeing my son struggle feel like we’ve have completly fucked him up.

Don't feel bad.
You have recognised the problem and you now know how to fix it.
But it is a long haul.
You have also realised this is a family problem. That is half the battle right there.
Once you get your DH onside you can both pull in the same direction.
He needs to read the ERIC website AND watch the Poo Nurses video. He needs to be 100% clear in his mind about what needs to happen and how long it will take.
I can't stress enough how important teamwork is.

Remember, a 3 yr old cannot make the connection between taking medicine and his tummy pain/bowel function.
So lots of bribery/praise for taking the meds, but very low key about doing poos. Let him do it in his nappy for now, The sight of the toilet probably inspires fear atm.
Once you have cleared the impaction and established regular bowel function you can begin to encourage using the toilet.
You will probably find you need to use movicol for years. That is absolutely fine. It won't do any harm.

Please don't blame yourself. It could just be caused by a slow metabolism or non-specific and undetectable genetic condition like connective tissue weakness that will go undiagnosed and cause no other problems.

Has anyone told you about crouching like we used to do before modern toilets were invented? It can really help peristalsis and natural elimination if you crouch down to poop, like you would if you had to wee or poo behind a hedge and like they used to do in France into a hole in the ground.

Place a shallow oval or rectangular dish / plate on the floor and get him to crouch right down low over it. Most children can do this as it's like crouching down to play marbles or jacks like we used to in the playground. You could put a puzzle or other game on the floor in front to keep him engaged. You could do a poo together like this to show what happens. I'm not joking. Good luck, it's not your fault.

I have bought big steps as advised by Eric so he can get that position but not tried what you’ve mentioned.

Yay, I like starbright's poo style! I'd agree that actually I don't think the step is enough to really shift the weight onto the legs rather than just sitting with legs up. Large potty, like the Baby Bjorn one, can achieve the crouching position properly ime.

We mix plain movicol with chocolate powder and milk. Much more palatable to our child. It is horribly stressful to go through but got easier when dh properly got on board with what was needed.

I think it’s no conincidence this has happened at a very difficult time for our family, hence the guilt

Has anyone suggested a glycerine suppository? The 2 gram children size. They are often the first port of call as don't affect the digestive system per se, just lubricate things to help relieve the blockage until dietary adjustments have started to improve things. They were a lifesaver for us.

Tbh, I think administering a suppository at this stage might be very traumatic.

Yeah I’d be up for the suppositories but docs seem really against this ?

Docs think up the bum stuff is inherently traumatic, I think - however, in our ample experience, trying to coerce meds down them in liquid form,.in large amounts, was way more traumatic (indeed, long-term) than strong enemas delivered by me at home. Hasten to add, this was a years not weeks timescale, so please don't worry on your DS's account.

PS if you're still having probs administering the movicol, using straws to drink can help them get it down more.quickly. We used to have some I bought specially with fake tropical flowers attached....or those silly straws that are glasses. God, fun times!!

Have tried straws, light up cup, I’m now making jelly and ice lollies, custard, etc etc... why are GP so against the suppositories? It’s totally normal in Europe. Don’t get it...

Also if anyone on this thread has a kid who only poos in their sleep I would love to hear from you. We don’t have any soiling atm just sleep poos. The withholding behaviours are extreme. Almost constant poo dance as I call it today...

Aw, sorry to nag on when you've already covered that ground! Ours wasn't a withholding issue, but I've def heard of the pooing only in sleep before.

For what it's worth, I think the nerve signals can be really muddle post-impaction; we've Def had times where it was almost like the body could feel it, and was fidgeting around, but the brain genuinely couldn't - was baffling.

Is he sitting down on loo and watching iPad or something any time he's fidgeting? I'd try to do that, with sweetie or whatever as a reward for trying for a few mins. So sorry - again, this is prob exactly what you're doing already.

Have a big hug - it's worrying and hideous, but it WILL PASS.