Painful Bowel Movements for 3-year-old

[mamama]

My son has had pain with bowel movements since he was 14 months old, and we have successfully managed it on and off since then. He's on medication to soften his stool. Every now and then it works TOO well, and I have to lessen the amount, but then he's in pain again. What's contributing to the problem now is his fear of having a bowel movement, and he holds it in as long as he can. He typically doesn't have a bowel movement for about 4 or 5 days. I don't know how to address the psychological problem. I'm pretty sure that at this point a huge amount of the problem (perhaps all?) could be solved by his not holding it in for so long. The doctor has not been helpful about the psychological issue. We have ruled out any physical problem. But the medication alone is not solving the issue. He has just potty trained, which I had hoped would make things easier on him, but it hasn't. Has anyone experienced anything like this? Any advice out there?

[pbjmama]

I would probably seek a second opinion from the doc. Also, I think even if it is working 'too well' you should continue the dose so that he can begin to have some time with out pain. A way of breaking the cycle perhaps.