fecal impaction

[rugbymom]

So, I haven't posted in here for a really long time. When my son was an infant, we had some worries over tethered cord, but an MRI ruled that out. He has always struggled with constipation, and now has an impaction. We are doing a course of Miralax thru the weekend and then will be talking to the GI again. For those of you who have been through this stuff, what do I need to know? What treatments have worked for you? What do you wish you would have known?

Background info: My son is 2.5 and is dairy/soy free due to intolerance. (We were actually just going to trial it when we found this out.) He drink almost no liquids (any tips on ways to increasing that would be awesome). He eats okay, but is limited by texture- no foods on spoons (ie. applesauce, soup, etc), nothing too crunchy like raw veggies.

I want to be really prepared when I talk to the GI, but am really bad at thinking of questions. What should I ask?

[heatherdeg]

SO get where you are. We avoided impaction through the use of baby enemas and 2-adults (one holding torso, the other legs) to push it out and almost had to go inpatient feeding therapy because he pretty much choked on everything. But mine was 13mo at the time and still bfing.

Oddly enough, it wound up being a gluten intolerance. Gluten doesn't appear to affect him in ANY other way--but will stop his intestines. We looked at the possible tests for Celiac, but none seemed conclusive; and our immunologist/allergist had told us that the best test of an allergy is to remove the suspect and look for a change--that no test was any better. So that's what we did. Of course, we removed gluten for other reasons, but this was a very welcome effect.

Since he's eating, the definite "poop pushers" are pears, prunes (which do NOT work for everyone), peaches, plums and apricots. The ones to avoid are bananas, apples and rice. In fact, you often find prunes mixed with apples so that parents don't inadvertently dehydrate their kids.

And water of course. Warm baths are SUPPOSED to help but never did anything for mine. I know others that have had great success.

You'll know to worry about impaction if he passes gas that smells like sulfur or rotten eggs. HUGE "get him help fast" signal. In addition to a hard abdomen--but you won't always have both.

Good luck.

[BookGoddess]

Originally Posted by rugbymom

So, I haven't posted in here for a really long time. When my son was an infant, we had some worries over tethered cord, but an MRI ruled that out. He has always struggled with constipation, and now has an impaction. We are doing a course of Miralax thru the weekend and then will be talking to the GI again. For those of you who have been through this stuff, what do I need to know? What treatments have worked for you? What do you wish you would have known?

We've dealt with this. What we found even more helpful than Miralax was Oxy-Powder capsules. We give 1-2 capsules and it clears out the blockage pretty fast. We give digestive enzymes with every meal and that has been a HUGE help for us. She used to be constipated but now with the enzymes, she has a BM nearly every day.

[MotherWhimsey]

My son is enema dependent and prone to impactions. What works for us is a pediatric fleet enema followed by an adult saline enema. Even still he sometimes gets them and we use a high volume milk of molasses enema. That one seems to work every time. Laxitives don't work for him and they just give him painful cramps and diarrhea leaks around the impaction.

Oh, and his gas can usually peel paint off the walls.

[rugbymom]

Thanks for the tips on how to tell if he is impacted. For some reason, I never suspected it, although I probably should have. I wonder how long he's been impacted for, poor guy.

BookGoddess (or anyone else) can you buy digestive enzymes in a health food store or only online? How do I know what is a good brand?

And as for the gluten thing...ugh. I would do it for sure for him, but it would be really stinky to have to remove another food. (I know- you gotta do what you gotta do...)

[MotherWhimsey]

well my son's on an elemental diet and it's still an issue, so it's not a given that removing gluten will cure it.

[Kailey's mom]

Originally Posted by MotherWhimsey

well my son's on an elemental diet and it's still an issue, so it's not a given that removing gluten will cure it.

Same here. As of now, we can NOT WHAT SO EVER miss giving dd her miralax, 1 full cap/day. If we miss it, she gets backed up, than it's 3 days of severe pain and finally she goes after a fleets *which is VERY VERY difficult to give to a child with sensory issues* If the miralax isn't working, we have to add colase. I thought the elemental diet would cure the problem, I was wrong. I don't think it's necessarily a dietary issue in some cases, my dd used to be able to drink juices, that only made her more constipated. We tried all the natural remedies, until we found out about her diagnosis. Eosinophilic Colitis. It causes chronic constipation, and I really don't quite understand it, but some kids just can't poop without help.

[mrsfru]

If something like gluten is contributing to the constipation, you'd know pretty quickly...and think of the relief. In ds1's case, we've been doing the Miralax thing (and then on to Lactulose) for 1.5 yrs, w/no real change. We took out gluten almost 3 weeks ago, and within 1 week stopped giving the lactulose and he stopped leaking poop and trying to hold it and started using the toilet. If it's going to help constipation, it can help pretty quickly. I know that many say that it can take months to rule gluten in/out for some issues, but for us, it was very fast. As soon as we blew it this week, he got constipated again and started trying to hold it again. (He has some SPD as well, so gluten affects this for him, too, hence some of the crazy behavior surrounding going to the bathroom!). Another great side effect of gluten free for ds is that so many of his food restrictions (the ones *he* imposes on himself) go away. He gained one whole pound in less than 2 weeks (he has barely gained, lost, and regained that one pound this whole past year!) He eats a lot more food and in much more variety while he is gluten free and seems much happier--even his teacher and his peditrician can see a difference (ahh...and his grandmother even commented as well!)

DS also has low muscle tone...and that can affect constipation as well.

We've been adding Buddy Bears digestive enzymes and probiotics whenever he will take them for years, and they do help overall.

hths

mrsfru

[rugbymom]

Well, this is day 3 of a high dose of Miralax. He is still just leaking around the blockage and now has a bad tummy ache. Is this normal, or should I call the doctor (I mean about the tummy ache)? We were supposed to wait till Monday to talk to doc again.

[Liba613]

Are you getting fluid in along with the Miralax? We saw, and were told, that Miralax won't do anything without the fluid.

We were told that my son needed two cups of fluid along with his cap full of Miralax every day and we can only count his formula for one cup of the fluid. The rest needs to be clear, either water or pedialyte.

[heatherdeg]

Originally Posted by MotherWhimsey

well my son's on an elemental diet and it's still an issue, so it's not a given that removing gluten will cure it.

Agreed that gluten is no guarantee and I didn't mean to make it sound that way. I was sharing our experiences as something to try.

Originally Posted by rugbymom

BookGoddess (or anyone else) can you buy digestive enzymes in a health food store or only online? How do I know what is a good brand?

We use Houston Neutraceuticals Zyme Prime and Peptizide. They make them in capsules, powder and chewables. I've only found that brand online.

Originally Posted by rugbymom

And as for the gluten thing...ugh. I would do it for sure for him, but it would be really stinky to have to remove another food. (I know- you gotta do what you gotta do...)

I feel your pain as we are gluten, dairy, corn & soy free. Can you say "fresh food ONLY"? But...

Originally Posted by mrsfru

If something like gluten is contributing to the constipation, you'd know pretty quickly...and think of the relief. In ds1's case, we've been doing the Miralax thing (and then on to Lactulose) for 1.5 yrs, w/no real change. We took out gluten almost 3 weeks ago, and within 1 week stopped giving the lactulose and he stopped leaking poop and trying to hold it and started using the toilet. If it's going to help constipation, it can help pretty quickly. I know that many say that it can take months to rule gluten in/out for some issues, but for us, it was very fast.

Granted, I think we really KNEW it was the gluten after 2-3 weeks, but certainly not months. Within 1 month, we were "cured" of the constipation issue. I don't remember if it happened the very first week or not--I'd have to go back and dig out my journal. That being said, my little guy was a lot younger than yours and wasn't eating as much food as yours might be--so it was really hard (since a lot of the baby stuff is heavy in gluten) but WELL worth it.

You can live with anything for 2 weeks. And if it actually helps, you'll never want to turn back. For us, it's been 5 years and honestly--I'll take it over the alternative. My son is only now (at 6yo) getting to controlling his bowel movements having suffered (what they said would be permanent) nerve damage in his anus from nearly 8 months of severe constipation.