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I can totally relate to this! I just solved the same exact problem with dd. Not sure if she was just holding them back, or if it was dietary or both, but dd was having the worst constipation. She'd work on them for hours and once I noticed blood spots on her anus after she pooped. So I went to the ped. and she gave lots of advice that has worked beautifully!

1) I put her on a constipation diet. No dairy (soy milk instead), no white flour, no highly processed foods. Whole grain everything, lots of fresh fruits, dried fruits, nuts, graham crackers and fig newtons for snacks instead of goldfish crackers. Unfiltered apple and prune juice. No potatoes. Bananas are also good. It's very crucial to stick to this diet closely until he starts having softer stools on a regular basis. Then slowly add in one "bad" thing at a time and see how it affects him.

2) Added some other essentials. 1/2 to 1 Metamucil cracker given over the course of the day in bites with drinks of liquid. In addition 4-8 T. prune juice. She likes the Metamucil crackers but hates prune juice and was not fooled when I mixed it with other juices. So I (sorry, I know this sounds bad) bought some fruit punch Kool-aid mix, and added water and 1 C. prune juice as the sweetener, along with either honey or Splenda, and she drinks it right up. But said it "tastes like raisins." lol! The diet and prune juice took about 5 days to work, and now she's going consistently every other day in the mid-morning, and the poop is not too soft or too hard. You may have to adjust the prune juice amounts according to his stools, but first give it a few days to regulate.

BTW the ped said Metamucil and prune juice given in small amounts like I'm giving is fine. It's not addicting and won't do any damage if I use it long-term. It won't prevent her food from getting absorbed in her gut by moving it through too fast. You really just have to tweak the prune juice. I started out with 1 T a day and moved until I figured out that between 4-8 T is what works for my dd. Any more than that and she gets the runs. Any less and she gets blocked up again.

3) I had to stop acting grossed out by poopy diapers and poop accidents. I didn't realize it but I was commenting on how stinky the poopy was and wrinkling my nose and all that. Had morning sickness which wasn't helping at all. She might have felt ashamed of it and tried to hold it in as long as possible and got constipated. We were also in the middle of potty training and I was letting her run around diaperless so she would have to poop in the potty, but instead she was asking for diapers and I was trying to encourage her to go on the potty instead. Got into a power struggle. She probably felt a lot of pressure. So when she finally had to poop, she was so blocked up that it hurt her to come out, so she would resist going when she felt she had to because she was afraid of the pain.

I changed my ways. I would ask her if she needed a diaper several times throughout the day and told her it was okay to poop in it. When she did poop I made a big deal about it and told her how happy I was. When I opened it she would say, "Yucky stinky" and act ashamed, and I said, "No it's a very nice big poo poo! Wow, such a nice one!" and she started to smile more and ask for more diapers on her own in order to poop in them.

Finally, 2 days back she actually disappeared and then came to announce that she'd pooped in the toilet. We were just floored! We had a huge party on the spot. Today she pooped again all by herself on the toilet and again I made a huge deal about it and did the happy dance and gave her lots of positive attention.

We are slowly letting her have limited amounts of dairy in her diet, and if we happen to eat out or at someone's house and she gets pasta or other white flour products I just make sure to give her a bit of Metamucil cracker for "dessert" (and plenty of water).

I really hope my experience can help your ds. I know how frustrating it is, and how helpless I felt.

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