Advice regarding pooping please

[sabby52]

Dec has been diagnosed with Severe Chronic Constipation, he takes 3-4 movicol a day and dulolax every evening. The problem is he has now seemed to have developed a fear of pooping, he does get severly constipated and he does have a little tear in his bottom from straining so i know it is sore, but we have got to the stage now that when he needs to go to the toilet he gets really anxious, he runs around like a headless chicken holding his bottom and he will hold his poop for as long as he can The worst thing is, because he gets movicol every day his poop is really loose so he does have little accidents, he will never poop himself but some will leak out

He is now in Nursery school and the teacher pulled me the other day to say that he had gotten really anxious and asked to go home beacuse he needed to poop So now I think this is going to affect him in school.

Has anyone been through anything like this and if so how did you handle it ?? I have had him to the doctors 683974744923 times and he has also been seen by a consultant in the hospital but it really does all boil down to sever chronic constipation

Any advice would be greatly appreciated

 

[sabby52]

Nobody

 

[sam2eb]

Aww how awful for him

Ive no experience of this but I hope someone has some ideas for you x

 

[isil]

I don't know. Is there no way the medicine can be changes a little so it isn't so loose? I'm sorry, didn't want to r&r

 

[sabby52]

I don't know. Is there no way the medicine can be changes a little so it isn't so loose? I'm sorry, didn't want to r&r

Over the past 18 months he has all sorts of meds, but movicol seems to be the best, I dont think the med is the problem I think the problem is that he has developed some sort of fear of actually going iykwim.

He has been potty trained for 2 year now and on Movicol for at leat 12 months, it is only these past 2 months he has started to do this

 

[polaris]

I have read that sometimes there can be a large hard impacted mass that they actually cannot physically pass, then if they are on laxatives the loose BM will leak out around the hard mass causing soiling. Could this be what is happening with your little boy? If that is the case, then the mass would need to be removed before his BMs can get back to normal. I would be inclined to bring him back to the doctor to be honest, especially if there is still an actual tear as that sounds like he is trying to pass a large BM and can't manage it. It sounds so distressing and awful for him.

I don't think you can do any sort of desensitization programme until the little tear heals up as it actually will be painful for him to go. After that, you can start a desensitization programme where you set up a routine for him to try to use the toilet twice a day (e.g. after meals) and you reward him for baby steps along the way. So at first you reward him for even just going into the bathroom, then you reward him for sitting on the toilet even if he doesn't go, then he has to sit on the toilet for a longer period and actually try to do a BM, and eventually he will hopefully get back to being able to pass a BM in the toilet without fear. I hope you get it sorted, it sounds so stressful.

 

[Blah11]

I was going to say the same as Polaris. If there is impacted poo in there, he migyht need to get manually removed horrid but best in the long run if he needs it and enemas dont work.

https://en.wikipedia.org/wiki/Encopresis

 

[cherryglitter]

same as the two ladies above. xx

 

[sabby52]

I have read that sometimes there can be a large hard impacted mass that they actually cannot physically pass, then if they are on laxatives the loose BM will leak out around the hard mass causing soiling. Could this be what is happening with your little boy? If that is the case, then the mass would need to be removed before his BMs can get back to normal. I would be inclined to bring him back to the doctor to be honest, especially if there is still an actual tear as that sounds like he is trying to pass a large BM and can't manage it. It sounds so distressing and awful for him.

I don't think you can do any sort of desensitization programme until the little tear heals up as it actually will be painful for him to go. After that, you can start a desensitization programme where you set up a routine for him to try to use the toilet twice a day (e.g. after meals) and you reward him for baby steps along the way. So at first you reward him for even just going into the bathroom, then you reward him for sitting on the toilet even if he doesn't go, then he has to sit on the toilet for a longer period and actually try to do a BM, and eventually he will hopefully get back to being able to pass a BM in the toilet without fear. I hope you get it sorted, it sounds so stressful.

He will eventually go to the toilet as long as I stand with him and hold his hand, its just the whole build up to it. He holds it for as long as he possibly can but in the end he has to go, he wont poop his pants so he knows he has to go to the toliet iykwim. I dont think he has a fear of going to the toilet as he still goes for wee-wees plus sometimes he will sit on the toilet and say that he is trying to poop, I think it more a fear of the poop coming out.

I really was thinking of starting a star chart as he had one before which worked a treat. As for his little tear, we have cream for that, so I am hoping it will heal quickly

Thank you so much for all the helpful advice, it really is appreciated

 

[sabby52]

I was going to say the same as Polaris. If there is impacted poo in there, he migyht need to get manually removed horrid but best in the long run if he needs it and enemas dont work.

https://en.wikipedia.org/wiki/Encopresis

That link is so interesting. Thank you

 

[NIfirsttimer]

as you know, im dealing with this too!
have you done a movicol clearout cycle recently? when Rube needs this we work up to 8-10 sachets of movicol per day, gradually over a week, she will have the runs and then a few days later pass a HUGE load of impacted poop thats been stuck behind there, so its important not to stop once they start to have the runs!

the other thing that has helped us recently is the 'magic' cream. its really a tube of bepanthen, but ive told Ru that its magic and makes it less sore for her to poop. obviously it doesnt, but it seems to be helping her, as she will be crying 'sore pooh' and not wanting to go, but will then ask for the cream, ill apply a little bit to her bottom, and she will then sit on the potty more easily.... totally physcological, but thats a big part of toddler constipation! Does he go to the monthly toddler constipation clinic at the ulster?

 

[NIfirsttimer]

also.. if Ruby is afraid i will sometimes use a little glycerine supposistary, it only produces a little bit of poop usually, but it gets rid of her being able to hold it in, and once the first bit has been passed shes usually not so frightened...