Constipated 4 year old... UPDATE Post 46

[NewCrew42]

Ouch! You're not kidding! Over $30 per case and a trial pack of just 4 is $6.95

DS8 has had constipation problems since he was 3. His underwear usually has "skid marks" on it. The doctor said that his colon is stretched and b/c of that, he can't tell or feel when he has to go. He told us to use the Miralax (1 full capful/day), just like the majority on here have said. He has seen a Ped. GI specialist as well. The speciallist told us to keep giving him the Miralax and increase his fiber intake as well as to have him sit on the toilet for 10 minutes, regardless if he goes or not.This was to get him used to being on the bowl.

I was doing good in the beginning with increasing his fiber intake and making sure to give him the Miralax every day, but I found after awhile, I started to forget mix it with his drink and we went back to square one. I can mix it in his juice in the morning, but he doesn't always drink it all (and sometimes not at all) with his breakfast. He's busy getting ready for school in the morning and I think he either forgets to drink it with his breakfast or is not that thirsty.

He's been on school vacation this week and I've noticed that he's been going to the bathroom to try and go on his own without having me remind him - FINALLY!! He has gone each time, but not before his underwear has a skid mark on it

I get the baby wipes for DS8 to use when it's dry and tp won't work. It definately helps, but there is a down side to it as well (besides having to throw them out and not flush them). DS had gotten used to using it that he wouldn't use tp when he was supposed to. I think he is finally past that though. He only uses the baby wipes when he needs to now.

Any suggestions on how to increase his fiber intake? What has everyone else used?

My DD had problems with the "skid marks." According to our specialist, this is common with these issues and isn't due to the child not wiping properly, but due to "leakage" of the stool.

As the child becomes more regular overtime, the child's colon will return to normal size, they will feel the urge to go and actually go, and as all of this progresses, the leakage stops occuring.

It's very important for children who do not feel the urge to go, to have an set time they spend on the potty each day.

So, stay with your Miralax, have a "date" for your child with the potty each day (ours was after school, mornings were to hectic and she couldn't relax), increase fiber, look for triggers for the problem, and get your child going!

Cheese is a huge trigger for my DD and she loves it. She just knows she shouldn't eat it. Also, vacations seem to get her off schedule as well.

And as a wise person once told "And this too shall pass!"

 

[badblackpug]

I work with a pediatrician who has a "poop speech." Before I start... she ALWAYS prescribes miralax....

She says that most kids who come in with constipation problems do not have any medical cause. Mostly it is because kids at this age are so busy they don't want to sit and take the time to completely empty their bowels. The either just don't go, or only go a little bit. Then it becomes painful to go and they hold it longer, actually making it worse. Her recommendations are to increase fresh fruits and vegetables and water intake. Also she recommends making sure they "sit" for a long enough period of time. Even if she has to bring a book or a video game.

 

[Sweetpancake]

I had the same problem when I was your daughter's age (the things you admit on the DIS ) My mom fed both my sister and I prunes, luckily we both loved them and they worked like a charm! I would still take her to the dr. to rule out any other problems.

 

[hambirg]

Oh. . your poor DD. I was very constipated at that age. . .as were both of my daughters. It was honestly a case of not wanting to go when I felt a BM coming. . .and then after holding it for so many times, knowing it was going to be painful and holding it more. The warm baths and diluted prune juice always worked. I hope that is just the case with your DD. Remind her that it is important to go the "first" time she feels the urge.

 

["Got Disney"]

my son had that problem at that age....he did not want to poop at all so he got all impacted...it is common however. What worked for him was to give him corn syrup, but he would take nothing else so the Doc said to use that and it worked great......and an enema but only when he got impacted. To this day at 17 he still will not go into a bathroom to go unless it is his own. He went over spring break for a college viewing trip for a week and did not go once.....UGH!

He never had any problem with the enemas either....was a willing participant.

One night my DH and I went out and left him with a sitter who was a friend...he had not gone in over 2 weeks and so we gave him a suppository....we waited for like 5 hrs and nothing happened. About an hr after we left he exploded all over the place....with diarrhea....the sitter said he had never seen so much...well...you get my drift ....good thing he was our best friend

 

[disneyquestions]

Hey guys - My little one has been on the prune juice / MiriLax since Monday (Has had 2 doses) and so far, no poop..... Should I be worried? Shes acting just fine, not in pain at all, but I would think that she should have gone again by now. I realize that she pretty much cleaned herself out after the enema, but still.... its been 2-3 days since she went last. Shes not a big eater though....

Thoughs??

 

[The Mystery Machine]

Hey guys - My little one has been on the prune juice / MiriLax since Monday (Has had 2 doses) and so far, no poop..... Should I be worried? Shes acting just fine, not in pain at all, but I would think that she should have gone again by now. I realize that she pretty much cleaned herself out after the enema, but still.... its been 2-3 days since she went last. Shes not a big eater though....

Thoughs??

You said she went 2 times on Sunday, so it has only been 1 day that she has not gone. Today is Tuesday.

Just continue to give it to her daily forever....My dd was on it for 5 yrs, I think.

 

[disneyquestions]

You said she went 2 times on Sunday, so it has only been 1 day that she has not gone. Today is Tuesday.

Just continue to give it to her daily forever....My dd was on it for 5 yrs, I think.

Ok! I'm just the over-worring mom I guess! lol I just never want to see her the way she was this past weekend. Poor baby.

 

[The Mystery Machine]

Ok! I'm just the over-worring mom I guess! lol I just never want to see her the way she was this past weekend. Poor baby.

I understand, BTDT.

The problem here is that when you have a constipation problem, the colon stretches out therefore it does "fill up".

So that is why you continue with the Miralax. Now she does have to be eating and DRINKING! Make she is not dehydrated.

My former constipated dd is still not a big drinker. She is 14 and I want her to go for a colonoscopy but she won't do it.

You really have to stay on top if it because you will run into the problem of anal fissures that are beyond painful.

Have you seen any blood in her stool? Sometimes the reason they hold it is because they have a fissure and man that is some pain.

So try and give her a balanced diet, fluids and her Miralax.

 

[disneyquestions]

I understand, BTDT.

The problem here is that when you have a constipation problem, the colon stretches out therefore it does "fill up".

So that is why you continue with the Miralax. Now she does have to be eating and DRINKING! Make she is not dehydrated.

My former constipated dd is still not a big drinker. She is 14 and I want her to go for a colonoscopy but she won't do it.

You really have to stay on top if it because you will run into the problem of anal fissures that are beyond painful.

Have you seen any blood in her stool? Sometimes the reason they hold it is because they have a fissure and man that is some pain.

So try and give her a balanced diet, fluids and her Miralax.

She is drinking - I give her an almost full water bottle of the prune juice / water / MiraLax mixture to bring to school, and when she gets home, she drinks another bottle of water. She eats a good amount at school - sandwich, pretzels, apple, and grapes (3 snacks at school) and then a snack when she gets home (now the snack is Activia) and then dinner. Shes not big into dinner most nights (though she just inhailed her dinner tonight!), but I don't see a problem with it - shes eating enough.

As far as blood in the stool, never. DH suffers from fissure, so I know how painful they can be. I've checked her out, and I don't see anything.

 

[diznygirl]

She is drinking - I give her an almost full water bottle of the prune juice / water / MiraLax mixture to bring to school, and when she gets home, she drinks another bottle of water. She eats a good amount at school - sandwich, pretzels, apple, and grapes (3 snacks at school) and then a snack when she gets home (now the snack is Activia) and then dinner. Shes not big into dinner most nights (though she just inhailed her dinner tonight!), but I don't see a problem with it - shes eating enough.

As far as blood in the stool, never. DH suffers from fissure, so I know how painful they can be. I've checked her out, and I don't see anything.

Severe constipation like your daughter's can affect the appetite. I'm not surprised she's eating a lot now that she's "empty!" Just watch and make sure she doesn't get backed up again. Having a set potty time, like after dinner, worked for us.

I hope she's on the road to recovery now, but don't be surprised if it happens again. It lasted until about 6 or 7 with us. Never diet - just plain stubborness.

 

[Disneychix]

I go through this with my DS (4) about every 3 months. He is scared of going on the potty and although we don't push him to he still gets constipated every now and then.

I did take him to the Dr last year. She basically told me "if I had a dollar for every constipated 3-4yr old..." She 'prescribed' the mirilax method. (I use generic brand from BJs-exactly the same and way cheaper!) I give him 1 cap full daily when I notice he's not regular until he becomes regular again- When he's regular I give him a 1/2 cupful 1x per day.
Good luck with your DD!

 

[Wishing on a star]

Yes, MM is right....
MiraLax is not like a drug/stimulant....
It is not an instant result.

This is slow, and safe, and effective thing....

You do not give a couple of doses, and then when she goes... slack off... the problem will very likely return!

You want to maintain this as a therapy until her system has had time to recover and to begin to work properly....

 

[MickeySP]

Mine is 26 so any problems in that area are now his

But - when he was a toddler we had the same trouble. I took advice from a friends Mom, she had 9 kids so I figured she knew EVERYTHING!

She advised me a spoonful of sugar( yes like the song) in about 8 oz of water. It ferments the matter and makes it easier to pass. I swore by it, and since it was no chemicals made me feel better about the occasional use.

 

[Pea-n-Me]

The purpose of the bowel is to absorb water from fecal matter. If the bowel is not working correctly, i.e. not absorbing water, there is diarrhea, or watery stool. This is what happens when you have an infection or inflammation of the bowel.

And then you have the opposite - if fecal matter stays in the bowel too long, too much water is absorbed, and stool becomes hard. Ideally, there should be a BM every day, or at least every other day in order for stool to have a "normal" consistency, i.e. not to hard and not too soft.

Fact: if urge to go is ignored, urge goes away. Stool stays in bowel too long. Constipation, i.e. hard stool (and it's problems, like hemorrhoids and painful fissures) occurs. Really, really important to establish bowel habits that include regular BMs.

In the case of severe constipation such as the OP's child had, there can be a "back up" of stool if several days worth has not come out yet regular eating has occurred. As others have said, the bowel can stretch out and the stool can become "rounded", which makes it even more difficult to pass, and/or it can back up further back along the colon and even futher into the small intestine. In this case, having one BM or even a couple simply isnt' enough to clear out the GI tract.

This is why, in the hospital, we go "from above" and "from below" at the same time to get the whole thing moving. And then the important part is to "keep it moving", as once the tendency toward this is established, it's something you need to keep working with - aggressively - over the long term.

As above, I've worked with this with patients forever. But I also had my own personal experience with my DS. He lost his bowel motility after a severe infection of the bowl (EColi). He would eat, and nothing would move. Pain was excruciating and he was even admitted to the hospital so surgeons could evaluate whether the bowel needed to be removed. We had to work with a pediatric GI specialist long term to heal the bowel and re-establish motility. And some of the things we learned there I've shared with you, like a daily yogurt, importance of not ignoring the urge to go and establishing normal habits, etc.

But the thing I haven't said here (I might have said it on the earlier thread) is that it's IMPERATIVE that you stay on top of whether your DD is having a daily BM or not and taking steps to see that she does. My DS at the time was 12 and I found I couldn't always rely on his monitoring this himself. We'd think he was ok and then found he hadn't had a BM in three days, then all hell would break loose. You NEED to step in here and work with this aggressively yourself. Your efforts will pay off in establishing normalcy if you put the time and effort in, otherwise this could become a long term problem.

My DS is finally doing better. He knows he has to watch what he eats - foods high in fiber and very nutritious. (Non-nutrious foods were highly dissed by the GI people, and probably rightfully so. No question it's a challenge in today's world but when you have issues like this, you need to make every bite count.) They encourage water, water, water. IME drinking something hot is helpful as it stimulates peristalsis. If your DD would drink something hot in the morning it might be helpful in establishing a "morning routine", then she won't have to worry about "having to go" at school, which can be a deterrent to going. This can be something you can work on this summer, but just sit down and establish a plan, share it with your DD so she knows it's serious, and then make it happen.

You can do it, Mom. Good luck.