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retentive encopresis - how to treat it

post #1 of 11
Thread Starter 
I have a 21 mo. dd who I believe, after doing some research, has retentive encopresis which is a hard mass of poop stuck in her colon backing things up. The poop that does come out either leaks around it or explodes out finally, thin and liquidy. We're running back and forth to the toilet all the time because she never knows when its finally going to come out. She cries and says her tummy hurts and she says she's scared. I've read that Miralax and enemas is the solution but I'm wondering if there's another way. I'm going to start giving her prune juice and flax seed oil today but I'm not sure that is enough. Castor oil? I read one account that said their toddler had to be on Miralax for a year. Isn't Miralax anti-freeze? That can't be good.
Has anyone experienced this and have any natural solutions?
Thank you.
post #2 of 11
Dd had major constipation issues from food intolerances (gluten, dairy, and soy). Does your dd have any other issues with rashes, ear infections, sleep, clingy, hyper, slow growth, etc? We "fixed" it by removing foods she's sensitive to, using digestive enzymes, probiotics, and magnesium citrate.
Here's a good page for reference:
http://www.enzymestuff.com/rtencopresis.htm
post #3 of 11
Thread Starter 
Yes! Thank you. That speaks because I have suspected allergies with her. She had major tummy pain/sleep and slow-growth issues for the first year of her life. At about a year old, I started her on goat milk kefir and bone broth and she started getting better sleep, poop and eating better. I assumed she was all better and stopped paying as much attention to her diet. Just this week I went back to taking out all of the top allergenic foods, doing the multiple elimination diet. Thought I'd finally do a trial with the foods. But I'm not sure I even WANT to trial dairy, wheat or... well, any of them, actually, until she's over this encopresis. But then how do I find out what she's allergic to. Testing, I've heard mixed reviews about... How did you do it?
post #4 of 11
Thread Starter 
And thank you for that reference site - very helpful!!
post #5 of 11
Thread Starter 
Oh, and the rashes, yes. In fact, her rashes have increased with the onset of this encopresis - makes sense. There's a bumpy one on her bottom and back of her thighs. And then she also gets these random somewhat circular shaped splotches. Right now there are a few in different places on her legs. But in the past, they've been on her back and tummy as well. Any suggestions there????
post #6 of 11
Are the splotches like hives or rashes? Because hives would indicate IgE allergy vs. an intolerance. You might want to get her tested by an allergist to rule that out, just in case. Start a food journal. And yes, taking out the foods that were a problem before is a great first step.
post #7 of 11
Rashes -we've had all kinds. Mainly small red dots on face around her mouth/cheeks, flesh colored bumps on her arms/trunk, 3 coin sized circular patches of flakey-looking (but not actually flakey) eczema of varying colors red to brown on chest, nape of neck, and left hip, red vulva/anus with or without red dots. I have figured that these come and go due to the efficiency of her detoxing (or lack thereof) in that sometimes they flair when she is sick and not just directly from food. Also, when they are constipated the toxins in the stool are reabsorbed into the body and have to be detoxed all over again so it is a vicious cycle.
I first cut all dairy since it is the most common intolerance, and actually I did this 4 times for six weeks, once I also cut eggs along w/dairy with no improvement. Finally I was desperate enough to cut gluten and bingo that cleared up most of her symptoms - enough so that a few weeks later I could tell that she was also definitely reacting to dairy. So we cut that. We had noticed a few minor reactions but couldn't pinpoint what they were from except to narrow it down to corn, soy, or eggs. So we just cut all those for a while and reintroduced corn and eggs about a month apart, but not soy since we don't eat it on a regular basis but figured that one out when dd had some of my gfcf chocolate bar with soy flour in it and reacted. I do not plan on trialing gluten, dairy, or soy anytime soon. I would love a small amount of dairy back and I am thinking maybe next summer trialing goat milk but only something cultured be it kefir, cheese, or yogurt. Yeah, my approach has been haphazard at best and represents the best effort I could put forth at the time. I have since found HCPs who could have helped me had I know them at the time I was figuring stuff out (both holistic type of MDs working in a mainstream setting - I was surprised), and of course others on the Allergy board.
post #8 of 11
Thread Starter 
I've since found out that the circular rashes are probably ringworm so I guess I'll get an antifungal cream for those. The other rash on her bottom and thighs is much better. We're on the fourth day of the multiple elimination diet. I gave her stewed prune juice and flax seed oil yesterday and today. She finally pooped this evening after not having pooped for almost two days. It was over an hour or so of going back and forth to the toilet. She screams and cries about sitting on the toilet still. As soon as she is on it, she wants to get up and I try to convince her to stay gently before it turns into a wrestling match . Is it painful for her to sit? So she had three big explosive poops that were loose and somewhat undigested. I don't know if the leaks before the explosion are because something is blocking it or because she's holding it. How does one know?
Yeah, I won't be trying soy anytime because I had tried a soy formula at one point when she was a baby and she projectile vomited all night long.
I have my 4yo dd doing this diet with us and her cheeks which have always had a little rash on them are clearing up. I wonder if its the dairy or the gluten...?
I thought goat milk kefir was what had helped to heal her gut initially, along with with the bone broth. (I'm pretty sure she had a leaky gut d/t my leaky gut from having a sytemic yeast infection during my pregnancy with her) Then I gradually shifted to regular dairy and she seemd fine for quite a while, but then... here we are. I'll trial it again some day too.
I wish I could find a local holistic practitioner to help but I haven't found one yet. It would be so nice to have some guidance.
I appreciate your sharing your story. Thank you.
post #9 of 11
Thread Starter 
Did you start the magnesium, enzymes and probiotics without trialing them? How long did it take before you saw relief?
post #10 of 11
Our DS (29 months) has been withholding poop since June. He had a couple episodes in April and May but started consistently holding in June. So far, he has not been constipated but he was having sore poops from what we know now are likely multiple food intolerances/allergies. This has been an extremely difficult situation for us.

We saw a pediatrician early on who recommended Miralax but we decided to first try natural solutions. Miralax is scary! There is a yahoo group that was started by parents who had children who had terrible reactions to Miralax. I highly recommend joining this list because there are many knowledgeable people on it who can help with more natural alternatives. What we did to clear the backlog of poop is bake pears (peel, dice & bake in the oven at 375 for 45 mins or so) and add a little prune juice (just an ounce or so to start.) We also gave a little bit of barlean's organic flax oil, which you can order online (don't overdo it, start with just 1/4 tsp a day.) We also ordered something called Fruit-eze, which we put in sunbutter and jelly sandwiches as the jelly (don't over do this either, a tsp or so to start.) It is all natural - prunes, dates, etc. We got the backlog of poop cleaned out this way.

However, it didn't fix the problem.

We started a very detailed food journal - logged every morsel and symptom. We also started to 'help' him poop by picking him up when he went to cross his legs, hold him in a squatting position, hug & comfort him, which relaxed him enough to go. This kept him relatively caught up (he usually was pooping out the food from 2-3 days prior.) The problem was, his diaper area seemed to always be sensitive and not really improving. At first we thought it was all because of the behavior (holding, smearing, etc.) and that did exacerbate it but now we know it was primarily because he was still eating foods he was sensitive to. We are now egg, dairy, soy, corn, wheat and gluten free. All the while, we eliminated a few at a time (in retrospect, this was a dumb thing to do, we should have cut it all out immediately. It was just hard because our diets were so laden with all the foods we were cutting that we were struggling with what to eat!) It wasn't until we eliminated wheat and gluten just recently that we saw what appears to be a big turn-around. He still needs to be held to feel comfortable enough to poop (he asks us to hold him and he still resists a while before going) but he is at least letting it out and his bottom is healing with no more obvious redness or rash from the poop. He is eating foods we suspected (peas, carrots, etc) with no issue. He even seems to maybe have picked up some weight already and tonight he pooped out yesterday's food. I'm not sure we've figured it all out but I see enough signs to be highly optimistic that we are finally on the right track.

When he was younger, we always thought maybe he might have food sensitivities but the rash was minor and intermittent and every time we eliminated something we suspected from our detailed food journal, it didn't seem to help and we couldn't pinpoint it. I don't know what mental block kept me from thinking 'WHEAT'. I think it was mostly because he would eat wheat on some days and things would seem okay. The delayed reaction plus the withholding behavior made it VERY hard to figure out. We should have just cut it all out.

Also, to start, when he started holding consistently in June, it was after a visit from our parents and we thought it might have been stress related - he has always been highly sensitive. Retrospectively, we realize he had really loaded up on all the major allergens during big family meal times! For example, at one dinner, he ate a ton of lasagna, filled with dairy AND wheat plus the acidic tomato, which just made it all worse.

My recommendation is to try simple nature methods first, prune juice, baked fruit (pears are awesome for pooping) and flax oil while immediately starting a total elimination diet (if you're still nursing, you'll have to totally eliminate too.) Try holding her when she has to go. If those methods don't work, try both the yahoo groups for Miralax and encopresis (let me know if you can't find them) because they have a ton of natural suggestions for constipation.

As for allergies, your ped can do a blood test or you can also look into these:

http://www.yorktest.com/ offers a finger prick test you can do at home for food intolerances.

http://www.enterolab.com/ offers a stool test for milk/soy/yeast/egg/gluten (and a gene test for celiacs)

https://www.alcat.com offers a blood test (a draw is required)
post #11 of 11
Thread Starter 
I only have a moment right now but thank you soo soo much for sharing your story and your support. Thank you!
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