Parachoc and chronic constipation

[Abigail]

So our DS has had chronic constipation for well over 12 months, probably closer to 18 months - 2 years. About 5 months ago we were changed from lactulose and coloyxl (which did nothing) to parachoc. We were told on initial starting that it would take a while to find the right dose and that he would need to be on it for 6 months minimum.

The thing is, it doesnt seem to be getting better, well its better than it was. The stools are soft but he is still not quite right. He was being regular and now he is back to a week between and he has still always insisted on being hugged or held to go. Im wondering about trying to increase the dose again, but then a ml more and he is literally diahorrea? And our GP said that after the inital workings that the dose we are now was good. To add to this his father believes he will/is develop a dependancy on it...

Im not sure what to do anymore

Im thinking about going back for a review especially as I need his father to keep giving it to him and Im worried he might not if he is really that worried. I havent spoken to him yet, but Ive seen what he is like on it. It terrifies me to make DS go back to that without it!!

So Im thinking of going for a review, but do we just stick with this, or could there be something else happening that we should ask to see a paed for? Also has anyones child developed a dependancy from being on it?

I would be forever grateful for any help and responses

[STARRYSKY]

Hi Abigail,
I have recently started my 2yr old DS on parachoc due to him holding on for 5 days and screaming and carrying on when he finally does. He is not constipated, he has been once and that once is what has led us to this.
Due to him being constipated that once he now fears doing a poo, I know his diet is great, he drinks plenty of water etc, so it took me a while to catch on to what was going on, I read a thread on here about using parachoc, so I went and bought some and gave it a go (after trying pears, apricots, prunes etc, all to no avail)
I have just spent half an hour looking for the thread Im sure infinity and Jackrose posted in and gave heaps of great advice but I cant find it!
will be back to write more, ds is having a hissy fit!

[jackrose]

Hi Abigail and Starrysky,

I have been through a chronic constipation issue with my DD and found the whole thing incredibly traumatic. Trauma watching my poor DD scream in pain and fear at doing a poo and trauma and frustration at the incredible lack of knowledge and misinformation out there about it. I now pounce on threads I see here relating to constipation as I completely sympathise and I feel the good info I eventually found should be passed on to people. There is a difference between 'short term'/'once off' constipation and chronic constipation and the second is not about diet, prunes, water, fibre etc.

Yes Starrysky, there was a great thread with heaps of good info in it but we lost it when BB went down last month! I have found some of it in my email account and here is a truncated version:

My experience:
At 18 months DD began a cycle of chronic constipation which was traumatic for both of us - holding on to poos, screaming, fear, fissures... None of the traditional solutions worked, prunes, dried fruit, increase in liquids, diet high in fibre, pears, prune or pear juice, etc. It was exhausting keeping on top of her diet and her motions. We couldn't leave the house on the days I knew she needed to do a poo as it would take all day and require lots of cuddling and sometimes interventions from me. I felt so bad for her and was at a loss as I knew her diet was wonderful. Pleanty of fluids and fresh fruit and veg.

Doctors said that some children just have slow bowels, but I sought other opinions. I just refused to believe that a child that had previously been able to poo without a problem could suddenly have a sluggish bowel. It just did not make sense to me. I figured there had to be more to it, had to be a reason behind it. I saw a nutritionist as well and she was dumbfounded. I had a month worth of records of food eaten and motions passed and she could not see any reason for DDs issues. We finally sought a referral to a paed GI specialist

The pediatrician threw out all of my carefully documented diet notes and told me that children's constipation is rarely about diet. Unfortunately we tend to treat children like mini adults and approach their medical care regarding constipation as if they are adults when their bodies work quite differently. This was the first thing I had heard in such a long time that was beginning to make sense to me. Basically, he explained that for children, constipation that goes beyond the short term is pretty much psychological. It hurts to do a poo, the child holds on. Finally they have to pass a motion and the result is of course a painful constipated large hard poo = pain. A-ha, the child thinks, "I knew this poo thing was painful" and so holds on again. So the cycle continues. So the trick to fixing it is to create an easy, soft painless poo for an extended period so that the child forgets the pain associated and can resume normal bowel habits. The best way to do this is to provide a laxative.

But not all laxatives are created equal.
-Fiber will bulk out the stools to help provoke a contraction and movement - not what you want here as you want the experience to be easy and not add to the trauma.
-Osmotic agents designed to pull water into the intestine, and again enlarge the bulk, stimulating contractions. Not great here as your toddler is desperately trying to avoid passing a big poo plus these laxatives can lead to dehydration (sugar is an osmotic agent and is often recommended for children with constipation. The side effect to using it is that it is also a substance that can cause constipation so in this situation is best avoided)
-Stimulant laxatives will cause increase contractions by irritating the bowel and can lead to a perpetuation of chronic constipation as they can cause 'lazy bowel' where the body becomes dependent on their use.
- stool softeners help liquids to mix with the stool to make it easier to pass and lubricants help coat the stool and bowel with oil which help make passing the stool easier. Definitely what you want in this situation.

The best for this situation is a lubricant and the one recommended to me was Parachoc. It is basically liquid paraffin which helps lubricate the bowel. I was advised to use parachoc daily (at an increased dose - 20ml or at least until you can see the effects of the oil in the stools) for at least 6 months. This will mean that the motions are soft and painless for a long period and the pain associated with doing a poo should be broken. You have to be religious about administering it, missing a day and causing a mildly firm poo will bring back all the fear again and set you back. We are just at the end of our 6 months now and I am in the process of weaning DD off it, a few mLs less every few days. The best bit, *it has worked*! DD now has a regular poo without incident. They are getting firmer and more normal as we decrease the parachoc and she doesn't seem to have a problem. (DD is now 2yrs 8mo)

I can't tell you the relief it was to get all this information and the relief I felt to firstly know that DD was not destined to a life of bowel trouble and secondly, I, as the person responsible for her diet, was not responsible.

I think this covers everything we went through and I hope this offers you some insight to your situation and some hope. All the best

We are now off parachoc after 7 months on it religiously. DD was weaned off, a few mls less every day for a few weeks. We have had no issues with her bowel movements since and now have a happy normal little girl. I cannot tell you the relief I feel. In my opinion from my understanding about how all this works, there is no way that you can become dependent on parachoc or other lubricant laxatives but you can get dependent on other types as they make the muscles of the bowel lazy. The issue with parachoc is if you are not religious about it. If you give some for a few days then forget every now and again, you go back to square one psychologically as the child remembers once again that pooing hurts... holds on more... gets more constipated.... viscous circle. You have to give it to them every day for the 6 or so months so they forget all about poo = pain.

Abigail, It sounds as if you should go for a review to put your mind at ease and make sure everything is ok with your boy. I am not sure where you are but I can recommend a great pead if you are in Melb!
FWIW I have been through 6 months of diarrhea like poo with DD on the stuff as I was advised to give a bigger dose of parachoc than the packet suggests to make sure all traces of pain/poo connection are abolished. It was a nightmare in many ways as we are using cloth too but I was motivated as I could see it working. It was only as we began to slowly wean her that her poos have become more formed again.

Im thinking about going back for a review especially as I need his father to keep giving it to him and Im worried he might not if he is really that worried. I havent spoken to him yet, but Ive seen what he is like on it. It terrifies me to make DS go back to that without it!!

I completely understand you are terrified, it was the memory of DD before parachoc that helped me remain disciplined and committed to the every day dosage! Excuse me if I am mistaken, but reading your comment above makes me think that you and your DS's father are not together any more? If he is incharge of administering it and is not doing so regularly it could explain why you are having one step forward, one step backward....

He was being regular and now he is back to a week between and he has still always insisted on being hugged or held to go.

Before I saw the pead I had tried parachoc on and off. I didn't understand the mind/body fear connection and how the parachoc worked and I also had a misguided fear of her becoming dependent on it. I would find that we would have a few days regular then go back to constipated when we stopped.

I hope this has clarified some things for you, if not, please let me know if I can be of any more assistance. And please keep in mind that it is always a good idea to get medical opinion if you are feeling nervous about something or that something is not right. Mother's instinct is always the best indicator when it comes to there little one's health.

And Starrysky
Things have improved?? I hope so, it does sound like it. So pleased to hear. My heart just breaks when I think of a little one straining to poo and a poor helpless mother having to watch

[tan32]

My DS is now 7 and has been on parachoc for at least 12 to 18 months, his first xrays came back and showed his bowels were blocked all the way up.
I was heartbroken for him.
He has it every day and we have tried to reduce his dose but at the moment we have to remain on it.
I have decided now to just continue with the dose and stop trying to stop giving it to him, his bowels need time to heal and re adjust and every time we stop we are basically having to start from scratch again.

I have however booked him in to the gp to have some follow up checks done to make sure nothing else is going on.

[STARRYSKY]

ahhh Jackrose! lifesaver you are! I didnt even click to the upgrade being responsible for the thread being lost, I was starting to think I imagined it!

Jacob has been on it for about 2 weeks now, 15mls every day, I use cloth too, so its lots of fun.

Jacob will go regularly now, he still has the pain association, I know when he needs to poo as he starts stamping his feet and squealing, he will come straight to me and want me to hold him, but now he will just double over on his way over to me and give a grunt, then straighten up and go toddle back off to whatever he was doing before, soooo different to before parachoc when he would squeal and then SCREAM while doing it, while I changed his bum, then cry for 15 mins afterwards.
so yes, we have progress! Thank you!

[Aligater]

Thankyou for this thread my 10 month old has had constipation that has got worse because she is holding on so now she is on coloxl drops and I have also been told to give water and brown sugar but I didnt know the rest about time on it to get over the fear

[butterfly_warrior]

I'm glad I read this thread. I've always thought Sam's bowels were a bit sluggish like mine, but Jackrose, everything you have said makes sense! I think we're only at the beginning of the holding on to poo phase. We're generally getting a poo every second day - they are becoming harder and harder. We don't yet have crying and carrying on when he tries to poo, but he's definitely holding it. And I think the events over last night and this morning are very telling. It appears that Sam ate something that disagreed with him. Massive spew with that distinctive sour smell and not at all like normal vomit smell. Followed by a poo-splosion in the morning. Same smell. But the weird thing was seeing this massive, hard lump of poo in the middle of the runny poo. Excuse the TMI.

I have coloxyl drops and lactulose in the house, but am assuming from comments that they don't work like the parachoc. I guess I'm taking a trip to the chemist. Hopefully we can get on top of this BEFORE it gets bad.

BW

[jackrose]

Starrysky, wonderful!! It is amazing what a difference having the right information has for something so simple like this!

It is such a pity that the knowledge about childhood constipation is not more widely known as it would save a lot of heartache for a lot of mums and bubs. This translates across a number of other medical conditions too. Some major changes could be made and ongoing difficulties avoided if only a mum's concerns were taken seriously and appropriate help sought at square one rather than brushed aside. I think it is a symptom of our medical system being so under pressure but I wish more GPs would refer out to appropriate health specialists. My grandfather was a pead and his words of wisdom were always - first and foremost listen to the mother, they know their child better than anyone and their instinct is often spot on.

I am glad Aligater and BW you have come across this info as it will help you avoid getting to the point I have Abigail, Starrysky and I have found ourselves. The chemist is a good place to start as that is where I got the first recommendation for parachoc - I just didn't realise the bigger implications for constipation/fear at the time. If your LOs are only just having shorter term constipation issues you will not need to go down the 6 month laxative path, you could just try the old faithfuls of prunes, pears, apples and lots of water solutions to make sure the bowels move. If things are a little more backed up Parachoc will help get things moving quickly so you can go back to more conservative natural laxatives.

If your LOs are already beginning to show the fear connection you might want to try using parachoc for a longer period, and after a few weeks try weaning off ever so slightly to see if the fear response has diminished. It is really only when we are talking months of chronic constipation that you have to resort to a longer term use to shake the association.

Once again, I don't think the sugar water is a good idea as it is counterproductive in the long run. There are so many other natural laxatives that are a better alternative and if those don't work a lubricant laxative is a good next step.

FWIW, I am only speaking here from my experience and understanding of the situation from my reading/researching/pead advice and I do believe that with medical issues it is part common sense and logic and part expert opinion. It is always a good idea to get some expert advice if your common sense tells you to!

Abigail, sorry to hijack your thread a bit. I really hope you find the answers you need here or when you get a review. Just keep in mind that it doesn't have to be like this. We went through almost 9 months of chronic constipation and once we had the right advice we never looked back. We are parachoc free and have no lasting issues.

[Nydia_F]

I personally feel that probiotics are superior to Parachoc because probiotics are often deficient in kids intestinal tracts and they provide support beyond just constipation relief.

Often mother's receive antibiotics in the hospital to stave off infection, but this often kills off the beneficial bacteria in the gut as well. That bacteria is supposed to pass on to the baby via the vaginal fluid during birth and via breast milk. But if the mother doesn't have a strong presence of beneficial bacteria then the baby doesn't get it either.

This leaves the baby constipated and open to all sorts of immune system problems. Beneficial bacteria literally defend the intestines from all sorts of bacteria, virus, and fungi. So if you can boost your child's immune system and get constipation relief it seems to me that should be option #1.

There are infant specific probiotics (some good ones made by Udo's & Renew Life) that you can put in the baby's formula. I did this with one of my friends whose baby had been constipated for over a week (and while in the hospital) and he was literally going within a few hours.

There are lots of studies and info on this - here area a few:

Study from Nutrition Journal: http://www.ncbi.nlm.nih.gov/pmc/arti...-2891-6-17.pdf
Article about probiotics: The Wonder of Probiotics