This is an ongoing problem. One that we (both my child and I) are very frustrated with.
The issue is he just. wont. poo.
It started when he started solids... but wasnt too bad until he weaned at 20 months (self weaned), then it became unbearable. For the last 12 months (if not a bit longer) he has been on parachoc. Even on parachoc he still refuses to poo sometimes. But he was going great with it for the last few months, we even manage to decrease his dose and keep him pooing without issue.
Well he had gastro a week back... now he is back to doing semi solid poos since the water consistancy of the gastro and he is again refusing to poo.
He quite obviously needs to go but refuses to.
I ask him why he wont poo and he tells me "It hurts". Nothing I do or say will convince him otherwise. Our lives revolve around poo and whether or not he has done one. If he has done one, it will be a great day, if he hasnt then he is miserable, his behaviour is terrible and he will eventually run around screaming because his body will eventually expell it against his will because of the parachoc.
I rang the contienence people and they will call when they have an appointment... no time line given on how long we will have to wait. Just reassurances that we arent alone and that this is normal for a lot of kids (not terribly reassuring when your child is screaming "no poo" at you in the background).
The GP wont refer us to the paed saying its all normal and psychological. But no mention of child psych or the continence people. I mentioned this issue to our MCHN and she was the one that told us about the continence people and referred us onto a dietian.
Thing is he eats well... really well... He drinks lots of water and exercises heaps.
I have another appointment with a different GP at the same practice that has seen DS before that I am going to push for a referal to a paed. We cant go on like this My baby boy is suffering and in 12 months we havent gotten anywhere further with this issue.
Thanks for that There is a lot of great information there but unfortunately not much of it new to us It feels like there is no end in sight for my little one Back to the GP we go and hope there is something, anything else that can be done
How old is he? There are books about doing poos like "Everybody Poops" for example too. Don't know if that was suggested in the other thread.
Probiotics, yoghurt or Yakult would be my other suggestion. Baby probiotics has helped my baby - I know they get a lot of natural ones from breastmilk too.
Last edited by emc2; August 2nd, 2011 at 09:08 PM.
Oh, Abigail. That must just be horrible for you both.
I think you are way beyond any of the normal remedies, way past pears, and brown sugar. If this has been going on for such a long time it is more than likely psychological.
I think your GP is negligent to refuse to refer you to a specialist. A specialist is exactly what you need. A GP is just that, a general practitioner. They are by definition, fabulous at being the front line in health care and should be ready to refer to appropriate specialists when things are either out of their knowledge base or not improving with the treatment plan they develop.
Please, get a second or even third opinion if that is what it takes to get some specialist advice. I had to see 3 GPs before I found someone reasonable enough to refer me. Once I saw a pead we were on the path to recovery and it was a really simple solution. One where I just needed professional and knowledgeable advice. If I didn't chase up that third GP, I would have absolutely been in your shoes, looking at 12 months of constipation. As it was we went through 8 months I think??
I say stick to the parachoc, I know you say you have been using it but there must be a reason it is not working. Forgive me if I am wrong with this, but for parachoc to work in chronic cases it must be given daily without fail. If you skip a day, skip a dose, you are back to square one. You must keep stools soft for a very long time for the psychological stress to wear off. I was also advised to give a dose higher than recommended on the bottle. I was told to give an amount that meant that I could see an 'oily' substance in the stools then lessen just enough so that it was just noticeable. This was to ensure that we were getting maximum benefit on the lubrication. I was also advised to not even consider weaning for at least 6 months and then to do it ever so slowly, decreasing by a few ml every few days. I really recommend you see a pead specialist so that you can get someone on your side and really feel confident about sorting this out.
I will try to find some more of the threads I have read and contributed in so you can read more of the experiences of people who have been through this. Taurean's experiences and advice in this thread, particularly her realisation that it was the way that she was administering the parachoc that made all the difference may shed some light on why things have not been working for you.
:hugs: The time of constipation in my house was terrible and my heart goes out to you and your little one.
ETA: I just have to respond to a few things in your OP.
With regards to chronic ongoing constipation in children:
It is not about diet.
Your GP's opinion that constipation for 12 months is 'normal' is sheer stupidity.
There is a serious misunderstanding of children and constipation and we have to stop thinking of them as mini adults. The reasons for their constipation and the solutions for them are not the same as for adults.
Last edited by jackrose; August 2nd, 2011 at 10:40 PM.
We saw the continence nurse and her basic response was "just keep doing what you're doing". *sigh* She did try to put it down to a fibre issue until I went through what he eats in detail and she quickly changed her mind. She also wants us to put him on the toilet half hour after eating if possible...
So nothing new.
We are now awaiting the paediatrician.
I also went through our diary of DS and he has has issues since he started solids pretty much so thats over 2 and half years, not all of those medically treated. It seems endless for him.
I totally understand what you are going through as I have issues with my (almost) 10yo. One of the ways I was able to get through to him was talking about how it hurts but it hurts more in the tummy if he holds on, and that once he's done it he will feel much better when it's out. But not when he's upset because they are not in a good place to discuss stuff then We had problems with DS1 until he was about 5 and still do if he has a gastro bug that upsets his system.
Its been a while since Ive been back in this thread and I thought I might update you all with how we are going. The verdict is we are going really well *touch wood*.
We saw the paed and his response was to change from parachoc to movicol and start a new toilet regime. I asked about if allergies or intolerance could cause the issue and was told that it would be like looking for a needle in the haystack and we would go down that path if the movicol didnt work. We had to go above recommended dose (on Paed supervision) to get things going and within two weeks DS was voluntarily sitting on the toilet to poo. The only issue being we once again couldnt reduce dosages after being on the movicol for a while.
After dealing with this issue so long I took DS to the dietitian basically with the viewpoint of "well its been this long even if they have nothing new it cant hurt". She was of the view that it was a fibre issue! So I humoured her and even created a spread sheet calculating the fibre vs water intake and she also concluded its not a fibre issue. We then eliminated the known allergens from his diet (we had been told previous to keep him exposed to build a tolerance to them by the allergist) and lo and behold he is on a significantly reduced dose of movicol. He willingly goes to the toilet now. And he doesnt scream to do so. He eats more, is happier and is like a new little boy.
Recently he was reintroduced to an allergen and the next day was back to his worst, screaming and in distress and pain like nothing before. So I think that is an unfortunate way to discover it, but reasonably conclusive indicator to keep doing what we are. We are also doing elimination diets to see if we can get him fully unmedicated. But honestly, I never ever EVER thought I would see my child go to the toilet willingly and without pain.
Thank you all so much for listening to my tears of frustration and concern for my boy. We're getting somewhere now
Great to hear you have some answers! Hopefully not long now until he gets of the movical. It is so hard seeing them struggle. We are in a very similar situation with DS2, he also started having trouble after introducing solids and every time I cut out a breastfeed he needed parachoc for a few days before I could slowly wean him of it again. I weaned him fully at twenty months (before Xmas) but this time I can't reduce the amount of parachoc as he will be constipated straight away. Just like your son he eats really and drinks lots of water. After reading up a bit more about constipation I suspect he might be intolerant to dairy. Just wondering if you wouldn't mind telling me what your son is intolerant of and if Movicol is better than parachoc for long term use? Thanks in advance!
Last edited by Esme; January 30th, 2012 at 12:13 PM.
Hey Esme Sorry I havent been around much so havent ignored you - promise!
Our story is pretty long but the main bits are as follows:
Like you DS weaned at 19-20 months old, it was then that his constipation issues really ramped up. Before this he had issues, needing coloyxl drops and lactulose all the time with varying results etc, no one really took any notice of us until our first anal fissure. Then we were put onto parachoc and told that its all psychological and very common. We were told to wait it our for 12 months at least on parachoc. No one was interested in an outside cause.
Parachoc for us had varying degrees of success, we were like you, never able to reduce the dose and we would still go through phases of screaming and large ball like poos. My first suggestion to you would be to get a bristol stool chart and become very acquainted with when your child poos, the amount of distress (if any) and what type of poo and amount you are getting. This will at least let you see if you are solving the problem or going through stages where you are just seeing overflow and then the constipation. For us Parachoc didnt actually dis-impact him, we know this from the x-ray and the fact that we had to go over recommended dose (under medical supervision) to dis-impact him with the movicol. Parachoc had its place in our journey but it wasnt the solution to our problem and in hindsight probably prolonged us more than we should have.
Movicol has been a miracle for us!! Like I said we started at over high dose to get him going. We started a new toilet regime which was just him sitting on the toilet, no mention of poo just sitting for 5 minutes at a time. He should have been at the point where he would wee and involuntarily poo at the same time but that never happened for him, however he did start pooing. He would get a reward (sticker) for each time he sat and a reward for each time he poo'd on the toilet. It was amazing to see. (I cried a few times). Within two weeks he was actually taking himself to the toilet. We were unable to reduce to the paed's recommended dose for him, but we are still within "normal" ranges.
So long as he had his movicol he would poo on the toilet, without pain and willingly do so. I never ever thought I would see him do that. Movicol for us was far more successful in one month than parachoc had been in a year. Safety wise they are both meant to be safe for long term use and not cause dependency, however parachoc has a long list of dos and donts whereas he can take movicol and continue on being a normal kid straight away.
Unfortunately our paed is not interested in looking for an outside cause to our issue. I was told on initial meeting that it will all sort itself out and if after another 12 months of movicol he doesnt poo without it then we will look for "a needle in the haystack". I wasnt happy with this response but I didnt know what to do.
For us it wasnt until DS was diagnosed with an inguinal hernia as a direct result of suffering chronic constipation requiring surgery that I went looking for more help.
I self referred us to the dietitian locally. For a couple of weeks I compiled our bristol stool chart in conjunction with a food diary while waiting to get in. DS has also previously been tested for allergies via skin pr!ck testing after an adverse reaction at 12 months old. So we already knew there were issues there.
The dietitian was only interested in fibre initially I did a fibre count chart showing her what he ate and what he totalled per day. He was low on the water side of things however she agreed, fibre wasnt our issue here. We then started elimination diets starting with the allergies and then moving onto fructose.
DS is allergic to 5 out of the top 8 allergens. (That is he has an autoimmune response shown via SPT to these, not just an intolerance response)
Egg (white and yolk)
Tree nuts (4 varieties)
Peanuts
Soy
Wheat
We are not allowed to introduce nuts of any kind so that was no issue, egg is highly unlikely to cause bowel issues so we continue with small amounts of well cooked egg to help him, we did eliminate wheat and soy completely. Within days DS had turned from "normal" poos (on movicol) to watery poos of huge proportions, He would go three times a day if not more, we actually had to cut down on his movicol lol!!!!
Day care stuffed up and gave him half a wheat-bix in their care and he was distressed and in severe pain the next day if not sooner and constipated. Wheat is definately one of our causes. We are just about to do a fructose challenge to see if we can move past it or not. And once we finish that, we move onto eliminating lactose and then challenging it. It is very common for kids to have lactose cause constipation so its a wait and see game for us. And if its not then we will move onto the next one. I dont recommend doing this on your own though, definately see a dietitian and/or allergist before trying any of these! DS is still medicated but he is now on his lowest dose ever! He goes to the toilet on his own, willingly and without pain!!
We are still looking for our needle in the haystack but we are closer than ever before to being fully unmedicated and "normal".
Thank you so much for taking the time to tell your story. It sounds like you have been through a really tough time trying to find answers and you must feel so fantastic to see some real improvements.
It is not easy to keep asking questions when nobody seems to have answers or does not seem interested in finding them. You are a supermum for following thorough! Much of your story makes me want to cry or scream (I hope the day care staff realised the ramifications of their actions and have taken serious steps to make sure such a mistake does not happen again) but I am so pleased to see you have seen some real changes in your DS, have some solid proof that there are real causes for his constipation and some ways to sort it all out. It must be such hard work to sort it all out and find that needle in the haystack but you are amazing for knuckling down and doing it!
When they just wont poo!?
My baby boy is suffering and in 12 months we havent gotten anywhere further with this issue.
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There is a lot of great information there but unfortunately not much of it new to us 
We had problems with DS1 until he was about 5 and still do if he has a gastro bug that upsets his system.
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