Constipation / encopresis? - Mothering Forums
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#1 of 13 Old 08-29-2013, 06:24 PM - Thread Starter
 
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DS is 7 and we have struggled with this off and on for a couple of years now. Part of it may have stemmed from a severe constipation issue when we travelled to a very hot area in a totally different time zone, and he got severely constipated from dehydration, schedule was off etc.

He has a few of the signs like underwear stains that he claims not to know about, and refusing to go when he looks like he needs to. Also, sometimes he'll sit for the 5 min, not go and get off the toilet. Then literally 5 minutes later he needs to go? Normal? It's all off and on. If I regularly get him to sit and try for 5-10 min after breakfast and dinner, he seems to be ok, and there's no real issue, but after being 'fine' for a few weeks, I stop the routine and let him just go on his own which he sometimes does, but other times he needs reminders. Left to his own devices, he goes maybe 3-4 times a week. Maybe I should just be continuing the routine all the time as he's susceptible?

So after three incidents last week (he was likely dehydrated from being sick), I bought the e-book The Ins and Outs of Poop, but I'm not sure if his case is severe enough to do laxatives for three months, etc. I've been getting him to drink more water, and along with the sitting down after breakfast and dinner, he is doing ok these last few days. I went to see our GP this morning and showed him the website I was looking at. He felt around DS's stomach and said I was overreacting and getting over anxious about this, and that if we sat him down twice a day, made sure he drank lots of water and got plenty of fibre, he'd be fine. He recommended prune juice, flax seeds, etc. We eat lots of fruit and veggies, he's allergic to dairy/egg, and we eat some grains but it's all whole grain, but I'm wondering if I should be adding anything else, or if I should be trying to get referred to a specialist who has experience dealing with this? Thoughts?

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#2 of 13 Old 08-31-2013, 06:00 PM
 
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Three to four times a week for a 7 year old doesn't sound like it's a real problem, certainly not worthy of a specialist, unless he is complaining about stomach pains for cramps.

 

Some kids start to be a little reticent to poop after experiencing a bout of constipation, because they fear it will  hurt. It sounds like you are doing all the right things and it is just a little stage he is going through. You didn't mention exercise. Exercise helps a lot to keep the gastric parts working well. You could also try adding a little flax seed or flax meal to some of the things he naturally eats. This would add some fiber. Keep up the fluids! good luck!


 
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#3 of 13 Old 08-31-2013, 09:06 PM - Thread Starter
 
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Thanks Lauren. Yes, I do think his situation is not so severe that we need to see a specialist. It seems if we stay on top of it, get him to drink more water and sit on the toilet twice a day, he's ok. If we forget and/or he gets dehydrated from being sick, then we get problems. I had been reading this site: http://www.theinsandoutsofpoop.com/ and he definitely exhibits symptoms but mostly after he's been sick. The one that stood out for me was the skid marks which indicates his muscles can't feel the bowel movt starting like regular people do. . . . Will keep on top of it and hope for the best.

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#4 of 13 Old 09-01-2013, 05:24 AM
 
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I don't know your son at all but I wonder if he would do better trying to take an approach of learning to listen to his body, rather than having you 'take charge' and tell him to sit on the potty twice a day. All kids are different and I have one here that would have 'not gone' just to prove  to me that he didn't have to go, whereas other children of mine would be fine with being asked to 'try.' They are all different. For some children there is this psychological component to using the potty that is stronger than for others (starting with when they are toddlers trying to assert their will), so you might just want to pay attention to what type of temperament he has and which approach might work better. Sometimes our own anxiety can make us ask things of our children that it would be better for them to learn for themselves (I am speaking to my self here!!)

 

P.S. My only concern about Dr Tom after looking at the website is that he is trying to make money. It seems like he might just share what he's found so that more people could be helped.


 
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#5 of 13 Old 09-01-2013, 06:44 PM - Thread Starter
 
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Thanks. Yes, I agree that some kids would purposely not go just because someone is asking them to go. However, we did the 'listen to your body' thing, and it ended up with him withholding, then it leaking out onto underwear and him not even feeling it coming out. So, I think the twice a day thing works and I just need to be consistent with it even after that bout is over. . .

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#6 of 13 Old 09-03-2013, 09:17 AM
 
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It can be a problem because even though he is pooping it may only be poop that is able to find its way around the blockage. I really recommend the Ucanpooptoo program. Bring it up when you take him to the doctor. My daughter is 5 and has severe withholding and encopresis issues. Its both a psychological and physical problem. PM me if you wanna talk about it. I know how frustrating it can be planning your life around your childs pooping habits.


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#7 of 13 Old 09-03-2013, 09:49 AM - Thread Starter
 
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Thanks for the info. You might be right. He has been going about once a day the past week or so. He seems to have to strain, though, so it's possible there's a blockage in there somewhere. The doctor did feel around his tummy and didn't say anything, though. Hmmm. I may try a mild natural laxative this weekend and see what happens? I had bought a bottle of Senokot once when he was really constipated a couple of years back, but never used it. I just went onto their site and found this: http://www.senokot.ca/en/managing-constipation/using-laxatives/  Any ideas on what type? I've heard of people on MDC talking about milk of magnesia, but not others.  Thanks.


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#8 of 13 Old 09-03-2013, 10:41 AM
 
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Originally Posted by Alison's Mom View Post
 

Thanks for the info. You might be right. He has been going about once a day the past week or so. He seems to have to strain, though, so it's possible there's a blockage in there somewhere. The doctor did feel around his tummy and didn't say anything, though. Hmmm. I may try a mild natural laxative this weekend and see what happens? I had bought a bottle of Senokot once when he was really constipated a couple of years back, but never used it. I just went onto their site and found this: http://www.senokot.ca/en/managing-constipation/using-laxatives/  Any ideas on what type? I've heard of people on MDC talking about milk of magnesia, but not others.  Thanks.

 

My daughter got so bad, that MoM stopped working because she would just hold it in anyways. We now use senna based medication. Its a stimulant, and she can not ignore the feeling it gives her. We give it to her daily, and she goes daily, but you may need to clean him out first with an enema to clear out the blockage. MoM is a little more gentle than senna as a daily medicine. I would give that a go first. You want to make sure he is cleared out really good before proceeding with maintenance therapy. You then move on to daily therapy to keep them going daily, so the colon has a chance to shrink back down. Then you wean of the medication very slowly, while encouraging good toilet habits. The Ucantpooptoo program really covers this all, and has some cartoons and diagrams that your child can play with to understand better how their body should work. It also has little games the kid can play, and walks parent and child through the issues with this problem. Some kids get over it easy, and some kids dont get over this for years. For my daughter pooping is still taboo for her, and until she is ready to mature and accept that its something we all do, she will probably be on daily medication. (We use chocolate exlax. Its senna based.)


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#9 of 13 Old 09-03-2013, 02:23 PM - Thread Starter
 
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Thanks for your insights on this. Hmmm, how do I know if there's a blockage unless I go to a specialist? My GP was pretty nonchalant about it, but did say to try drinking more water, eating fibre and sitting on the toilet 2X/day, and then come back to see him if there was no improvement in a month. He is willing to sit and try, and a few times he's spontaneously gone in the middle of the day. Now with school starting, though, I don't think he would go at school unless he was desperate, and would just hold it until getting home. If I didn't do an enema (I think he would be traumatized by it), would MoM eventually clear out a blockage?


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#10 of 13 Old 09-03-2013, 07:20 PM
 
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Originally Posted by Alison's Mom View Post
 

Thanks for your insights on this. Hmmm, how do I know if there's a blockage unless I go to a specialist? My GP was pretty nonchalant about it, but did say to try drinking more water, eating fibre and sitting on the toilet 2X/day, and then come back to see him if there was no improvement in a month. He is willing to sit and try, and a few times he's spontaneously gone in the middle of the day. Now with school starting, though, I don't think he would go at school unless he was desperate, and would just hold it until getting home. If I didn't do an enema (I think he would be traumatized by it), would MoM eventually clear out a blockage?

 

You could titrate the dose of MoM until there was watery stool for a couple days. They diagnose by x-ray usually. Pick a time he will be home lots. Here is a chart with dosing instructions. The article is a good read.

http://pediatrics.about.com/cs/conditions/l/aa070501a.htm

 

ETA: Do lots of fluids with the MoM, and with any other medications, because the medications help the fluid enter the stool to soften it up. They really dont work well without fluids. My DD loves hot chocolate so I give her a mug of it with meds, because I can get her to gulp it down.


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#11 of 13 Old 09-03-2013, 09:27 PM - Thread Starter
 
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Thanks for all the great info. I found a fibre supplement today that I will give him while I consider all the options. . . .

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#12 of 13 Old 09-04-2013, 07:07 AM
 
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Thanks for all the great info. I found a fibre supplement today that I will give him while I consider all the options. . . .

 

Glad I can help. I get how frustrating it can be. Dont be afraid to ask your doctor, and if you dont like what he says, get a second or third opinion. Encopresis/fecal retention is different than constipation.


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#13 of 13 Old 09-04-2013, 10:28 AM - Thread Starter
 
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Yes, VERY frustrating at times. Good advice about the 2nd opinion. I'll see how it goes the next few weeks. Thanks again.


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