When they just wont poo!?

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.

:hug:

Raven, how do you do it? Is there any underlying cause for your boy? Or is it a case of holding on for them? Does it get better?

He has Aspergers and apparently it is common for them to have slower digestive systems, but I think his troubles started after a dose of antibiotics for a chest infection left him terribly constipated :(

I really think addressing the issue by acknowledging it hurts, but he will feel better one it's done was the best way. I tried bribing and yelling (not my proudest moment) without success. 3-4 yo's are shockingly stubborn too so if you can ride it out till he's a little older and able to be reasoned with. Our paed says that kids can be on parachoc for years if they need to be because it's not going to make the bowel lazy by chemically stimulating it like a laxative does

I've found with other things too that using the be brave approach works well. Recently C needed to get stitches in his chin and was terrified so I used this tactic and it helped somewhat.

Ive been there :hug: I think we both get as frustrated about it all as each other which in turn doesnt help either of us.

Paed appointment is slowly drawing closer. We have a few other issues going on 'down there' at the moment that I want the paed to double check also.

Ive tried the 'it will tickle' and ' it will be uncomfortable but it wont hurt unless you hold on' approach which have both worked to various degrees. But they obviously arent for the 'ive been holding for days and its going to be a whopper' ones.

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 :D

Oh, I am so thrilled for you, AND for your little boy. :leap:

Well done you for continuing to look for answers, for helping him and for finding the solution. You must be so relieved and so happy to have an answer.

Yay yay yay for pooing!!!

I hope that you keep working in the right direction.

I'm so glad you have some answers.

Hi Abigail,

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!

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!

x

I was just wondering how you got your DS to have the movicol?
DD is on it but refuses to drink it...