Constipation/pooping woes w/potty learning aged children

[mata]

I see on another thread there are others able to commiserate with this? Anyone else want to share stories and maybe find things to help?

In the past couple of months my 3 yo dd has developed a pooping phobia-more than likely caused by a bout of constipation. Now she's not exactly constipated, but she is holding it and I think her fear of it is also linked to it being icky in her diapers. I know the fear will improve once that ends. But she is absolutely terrified of doing it on the potty and thinks it's absolutely impossible, no matter how much she reads and hears to the contrary. I don't push her, but since I do think she would feel better about it once she stops going on herself I'm taking a couple of steps to help her over the hurdle. Today she had her first chiropractic adjustment and there was a lot of blockage going on in that area of her spine, so getting that to move has to be a good thing. I'm always trying to introduce water packed fruits and veggies, unfortunately, she's extremely picky and that's a major challenge.

I think about her issue in terms of the chakras, and as it's her root chakra that's impacted I wonder about her feeling of connectedness with her tribe. She's our second child, and prior to her we were very "only child" oriented. This is an interesting link about that concept:

http://www.catalystmagazine.net/issu....cfm?story=819

Anyway, anyone else?

[goddessjulia]

long, and warning: details! :)

hi mata! it might have been me you read on another thread about this I'm not happy for you, but glad to know I'm not alone! ds is almost 4 now and he swears he CANNOT poop on the potty (his emphasis). we started with constipation and painful bm's, which resulting in retaining, which produced severe and chronic constipation, which resulted in him passing absolutely nothing for 2 weeks at a time multiple times. I tried it all-- more water, more fruit, more juice (what kid doesn't like juice??? oh, yeah, MINE! ), prune juice (although I really could have slugged the "my kids don't have this problem" person who suggested in seriousness that I try to get a 3 y.o. to drink prune juice : ), fiber supplements, etc etc. brown sugar worked once, but not completely, then after that he wouldn't touch it because he knew I was vested in getting him to eat it. sugar!! it was insane. and forget trying to get otc laxatives in him. I ended up wearing milk of magnesia and castor oil (another great suggestion from someone with no kids). so, realizing what the heck, he's already laxative dependent, I searched and finally found the right info (for us) online. if you get into this level of chronic constipation with a child of any age, their bowel has stretched out and their nerve endings in the rectum have lost their sensitivity. all the natural remedies (if the child will even eat them, which is usually a major battle in this age group!) won't really relieve it, which causes it to perpetuate. I made this mistake for about a year. if I had it to do over again, I wouldn't have waited so long to get really aggressive treating it, and he might be poop-trained by now, although maybe not. (he's been out of diapers for some time.) but anyway, basically if you get into what I have gotten into, you have to keep the poop so soft that it cannot be retained, for a minimum of 3-6 months, often for a year or longer. this is to allow the bowel to regain its normal shape and the nerve endings to recover their sensitivity. I found a prescription laxative that has been studied for use long-term in children (I actually found the safety study, surprisingly enough). I was satisfied with the safety results and also with the fact that it dissolves in any beverage, unlike anything else which I can't hide in anything. he's been on this stuff (miralax, glycolax is the generic name) since april, I think. it's a far cry from crunchy : but as long as he doesn't miss a dose he doesn't get completely blocked anymore. he also is no longer afraid of pooping. but, with all the stress around the topic, this has become a battleground and we're not out of that phase yet : I don't think he understands his signals, and he definitely doesn't understand that it's important that he let it out. he still tries to keep from pooping pretty much every time, he just can't hold it in. I think we're getting more into a phase where he just doesn't want to stop what he's doing to go. he has had some successes going to the potty, so I should focus on that and know that he will get there, but it's soooo frustrating! and I lose my temper a lot, way too much

anyway, this has gotten pretty rambly I should probably stop while I'm behind! hope some of it is useful, or at least comforting!

[mata]

Hi Julia-I did see you on the other thread and really felt for you two! I've never dealt with these issues before, and they can be really, really stressful, can't they? You just hate to see them go through that. I hope things keep getting better for your ds-you've sure been down a long road with everything he's gone through. I'm not super worried about dd yet-her longest stretch w/out going is 3 days, and she usually goes every other day, and her stool isn't hard when she does go-but she does cry and freak out. I'll talk to the doctor at her 3 year check about it. Hopefully there's nothing physically causing her pain. Thanks for the feedback-it's a relief to talk about it-you know how it is when there's something up with them and it's on your mind.

[P-chan]

This is my tribe! My 3.5 year old son has had pooping woes on-and-off for much of his life.

In his case, what comes out is rarely hard or painful. He's just really really good at keeping it in. In the best of times, he poops every other day. In the worst of times, he can go 5-7 days. This alone wouldn't be a problem--I really do consider it his business--but his behavior gets so atrocious as he's desperately trying not to poop. He can't concentrate, tries to hit and bite, whines, squirms, makes it hard for anyone around to think of anything besides his impending poop. This behavior can go on for hours, even days.

So now I'm trying to focus more on the pre-poop disruptive behavior. I actually booked an appointment with his pediatrician just for her to talk to my son about digestive health, and she gave him a letter with a few points to remember (e.g., push when your body tells you to push). This worked for a few weeks, but it's gotten bad again. I have to remind myself daily that it is his job to poop. I cannot poop for him.

We also use the prescription laxative regularly. It does work, although I often have to tinker with the dosage to get it just right. Too little and there's no effect, too much and the urge to poop is so overwhelming that his behavior gets even worse.

I really don't care when he decides to put it in the toilet, although he's saying he's going to start both peeing and pooping on his half-birthday, next month. I'll gently encourage the pee but he can take the lead on the poop.

Goddessjulia, I'm so with you on feeling a bit peeved by advice from people who don't have a clue how serious it is. Every time I see a certain mom, she has another tip for me. Last time, she insisted that if I bought a certain brand of whole-wheat cracker everything would clear right up. I looked at my son, who was chugging his prune juice WITH THE LAXATIVE MIXED IN IT, and wished that it was a matter of crackers.

Mata, did the chiropractic work help? I've always been intrigued by that possibility but haven't looked into it.

[**guest**]

My son has chronic constipation. His doc just keeps pushing glycolax. He, too, wants the stool to be very loose.
My problem is, if ds basically has diarrhea every day, he can't go to school.

So, I don't know what to do. sigh.
I do think ds holds it in when he can. It's so frustrating. And ds refuses to poop in the regular toilet...Only on his little potty or occasionally a diaper.
It makes me want to cry.

The doc wants to do an xray but my son is on the autism spectrum and would NOT lie still for an xray. I don't like the idea of sedating him because I have a sensitivity to those kinds of meds and I'd be afraid that ds could react to it too.

[P-chan]

OdeToJoy

I don't mean this to be an unpaid endorsement for Miralax, or tell you what do--but if you want to know more about how Miralax might work, here it is:

My experience with Miralax is that it generally produces large, wet, soft BMs. Not frequent or watery like diarrhea. Our usual method of using it is if my son is withholding for a long time (during travel or illness, 5+ days), I give him 1/2 an adult dose until he has a big soft BM. This might take 2-3 days. After the unclogging, as I think of it, I give him 1/4 an adult dose for several days/weeks/months. This produces a normal-looking BM about every other day (with all the attending behavior issues that I mentioned above, unfortunately).

Your son might react differently, of course. My point is, you might be able to find the right dosage (maybe try different times of day? every other day?) so it's not an issue at school but still gives some relief. You could also try the "unclogging" during a school holiday and have at least several days or a week of big soft BMs before scaling back.

Why does your dr. want to do the X-ray--what might it show?

[mata]

p-chan-haven't seen any direct results (today is day 3 of no poops) from the adjustment, however-her mood is much improved, and she hasn't been complaining about her stomach hurting as she was doing before. W/chiropractic it may take a few adjustments to see if it has any physical impact. I'm going to take her once a week-it can't hurt.

She has a regular doctor's appointment on the 28th-I hope to get a better handle on things. I want to write more but have to pick her up-will be back!

[ledzepplon]

I don't know if we fit here or not, since dd has no problem pooping on her potty or with constipation. But her issue is huge poops. I mean, she's clogged toilets with poo only (no toilet paper). I'm not sure what to do, since she doesn't act like she's in any discomfort before or after a bm, and she goes like clockwork every day. I thought it was just a plumbing problem, but after reading some other posts about constipation, I'm not so sure.

Hoping to find some enlightenment here!

[**guest**]

Originally Posted by P-chan

Why does your dr. want to do the X-ray--what might it show?

It could show if he has an obstructed bowel.

Tried Miralax, gave ds massive cramps and explosive diarrhea. Not good.

[P-chan]

Oh, it didn't click that you'd already tried it. I'm so sorry that you're back at square one.

[goddessjulia]

long again! :)

odetojoy! mata, I want to thank you for starting this thread! this is a really hard thing to deal with, and the only people who get it are people dealing with it, like us.

I can see it being a problem going to school with the miralax. I haven't found the right balance with ds and he's been on it for a few months. a big part of the problem is that he still tends to retain, so I can't really let it "firm up" or he'll totally stop. I have had similar results to the pp who described the "unclogging" it runs about that way here, too. if we miss a dose, or a few doses, then it takes half an adult dose for 2-3 days before the blowout my plan has been to homeschool anyway, which I guess alleviates some pressure (no pun intended) in one sense, but otoh I could stand a bit of a break! but there's no way I'm sending him into a school environment where he would be at risk for being teased about this, and my choices around here are solely very mainstream. I think they might require that he wear a pullup, even, which would totally not fly with him (or me).

all that said, I wouldn't give up on the miralax yet, odetojoy: try a lower dose, maybe a much lower one, if you haven't already. it is much less irritating to the GI tract and causes less gas and cramps than other laxatives, but of course that doesn't mean it won't cause *any* for *anybody*. I hope you find something that works! I would suggest magnesium citrate but it is definitely a "blowout" type, and you can't use it long term (magnesium can be toxic to the nervous system if taken too long, I learned on this journey).

behavior is a big indicator of backup at our house, too. I really have to remind myself when he hasn't passed anything in a few days, because he'll get soooo cranky and difficult! it's hard not to lose it

a reminder: poop doesn't have to be hard for there to be constipation. also, a child who doesn't go every day isn't necessarily constipated. we're blessed with irregularity as a personality trait here (it's really a blessing, it's really a blessing...) so I honestly have no idea what normal is going to end up looking like for ds! hard to aim for something when you don't know what the target is :

whew! sorry my posts are so long on this! I guess I really needed someone to talk to! it's really nice to get sympathy and encouragement instead of disdain and lectures

[**guest**]

I'll stick with Glycolax for now.

[Maman*Musique]

My son suffered with this for years. We finally had success with liquid calcium/magnesium prescribed by a naturopath. He was 4.5 when he stopped withholding. It was a nightmare that lasted for over 3 years

[mata]

well, today wasn't that great for us-in the early afternoon she started looking like she had to go (day 3) so I braced myself. She started doing laps around the kitchen island on tiptoe, crying-and nada-so I know she was holding it. Two hours later she couldn't hold it anymore, and there was lots of crying, and "owie!" as I was cleaning her up. Started a log so I can bring it to the doctor.

Thanks for mentioning calcium/magnesium supplements, Maman Musique-I'm going to read up on that. I've put her on probiotics, too. Oh, and I have to remember a warm water bottle helps, too.

[aprildawn]

Hey. My DD1 recently started having problems in this area.

She had a very brief bout of diarrhea, literally a one-trip-to-the-toilet thing. After that she spent a month constipated because she was afraid it was diarrhea again. She'd hold it for two or three sometimes five days. I actually think she had encopresis because she'd leak poop into her panties. The leaking got worse and worse every day that went by. We finally got her going every day.

Then she started up with the constipation again. Just a week ago. I have no idea what triggered it this time.

She's 4.5 and has literally had no problems with constipation until the past 2 or 3 months. We've not medicated her yet or even seen a doctor. I thought that first time was just a phase and we'd be through it. Unfortunately not the case.

When she's constipated she leaks loose poop around the clog into her panties. She can't hold it in. The nerve endings in her colon are so shot she can't tell when she needs to pass gas and when she needs to poop. We can't go anywhere because she'll mess her pants in the store, at the park, at a friend's house, at dance class.

As of tonight she hasn't got for three days. From the last experience I know it gets worse every day that goes by. I'm not sure what we need to do to get her off this habit.

[robinkate]

When dd was about 2.5, she figured out that she could hold her poop in and we're still struggling with it (nine months later). I have been taking her to a chiropractor, but I'm not sure that the adjustments have helped much. I give her milk of magnesia about once or twice a week and that is enough to keep everything moving along. Right now I can't imagine that she will decide to go in the toilet, but am hoping one of these days she will realize pooping isn't that scary.

[ZenMamaJen]

I'm sooo happy to see this thread.

My 3 year old dd is having the same problem. Hard poops that take her forever to get out, and she won't go near the potty to poop. It is really stressful!! It's nice to know that we are not alone in dealing with this. I feel like she may never use the potty (she's still in diapers 95% of the time).

I've found that kefir smoothies with some CLO in it helps, but as you all know, once they know you REALLY want them to drink it, they refuse. I was thinking I may try cal/mag Floradix supplement? I take magnesium fairly often as I tend to have the same problem. She will eat prunes, but if I push them...see above.

[goddessjulia]

Originally Posted by P-chan

So now I'm trying to focus more on the pre-poop disruptive behavior. I actually booked an appointment with his pediatrician just for her to talk to my son about digestive health, and she gave him a letter with a few points to remember (e.g., push when your body tells you to push). This worked for a few weeks, but it's gotten bad again. I have to remind myself daily that it is his job to poop. I cannot poop for him.

P-chan, that is sooo true! I think I'm going to make myself a sign that says, "I cannot poop for him." did he really understand all that from the pediatrician? I've tried explaining things like that to ds but he just gets furious with me. he'll be 4 in about 6 weeks.

MamanMusique, it's good to hear a success story! I would also like to hear more about this supplement. did you go through a period where you had to use miralax too, or some other laxative? if so, how did you make the transition?

Aprildawn, that definitely sounds like encopresis to me. since your dd is 4.5, maybe you can ask her about what's going on, and talk her through it? have you tried anything yet? knowing what I know now, I wouldn't let it go too long, but you could start with intensive dietary efforts and if you can't avoid it, go for the laxatives. if she understands, she may be old enough to cooperate with taking fiber, etc. (I don't know if 4.5 is a very cooperative age, or if your dd has a cooperative personality! ) the longer this goes on, the more her colon will get stretched, which will make it physically harder for her to get back "on track." hth!

con leche!

yesterday we went through about six pairs of underwear; today we dropped two miniscule presents on the floor at nana's. tomorrow will probably be a blowout day. I really wouldn't care if he only pooped in his underwear, if he'd just let it all out!

[P-chan]

Originally Posted by goddessjulia

did he really understand all that from the pediatrician? I've tried explaining things like that to ds but he just gets furious with me.

I think he did. He really, really respects our pediatrician's authority, and she takes that respect very seriously. She's also a mother of three and knows how to talk to kids. Her main points (some of them were my ideas--we conspired by phone before the appointment) were:
1. Basic digestive workings (tube to stomach, intestines, etc), with diagrams
2. If the poop stays inside, his tummy gets bigger and bigger, and that hurts.
3. Holding it in is what is scary and painful--it's not healthy. The actual pooping feels good, because that's what his body wants to do.
4. He should listen carefully to his body, and push when it tells him to push.
5. Everyone poops--even the doctor! Most people poop every day, or about every day.

I made sure she wouldn't talk about the toilet at all, because my main goal now is just normal pooping.

Sigh, tomorrow will be Day Three.

[annekevdbroek]

Just signing in as another member of this tribe. My son is almost 3 1/2 and has been on Mirlax for a long time, and refuses to poop anywhere but the diaper. For quite a long time (a year+) he'd hold poops in, even with the miralax, for days (a week). His behavior would deteriorate because he was so uncomfortable - and as PP have stated, you can't poop for them.

We are on a regular poop schedule now and he consistently asks for a diaper, but is no where near ready to poop in a potty. I need to schedule a f/u with the gastro to discuss the next step (tapering Miralax maybe).

A PP have stated - the give them a whole wheat cracker or fruit juice advice is a bit frustrating when you have a determined non-pooper with underlying medical issues related to chronic constipation.