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

Ps who fucking knows re suppositories...quite agree it's a cultural issue

He is clenching everything until asleep.
Suppositories can be useful but it really depends on the child and the relationships etc.

Do you think he would be comfortable and relaxed for you to do the suppositories?
If you are confident of that then try that. Sometimes they fall straight out again
You do need to know how to do it correctly.

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...

Good luck tonight

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

Thanks everyone (insert poo emoji)

How is it going?

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.

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 - 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.

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.

Thank you endoftheline, will try upping the Movicol.

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?

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!

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

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

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
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.

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

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

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 ?

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

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.