Ahhhh Constipation

Lisa - posted on 09/18/2012

Even though this original post is over 2 years old, I will continue with advice and our own experience for others who could benefit.



Our son was in the hospital for 4 days with a severe impaction that could've taken his life. That was the first time we saw a specialist. The thing is, this condition can happen a lot faster than most people realize, however, the habits and conditions that lead up to it can happen over time. Our child used to hold it because passing the stool was too uncomfortable. SPD complicated the issue further.



Encopresis (leaky stool, in layman's terms) is a symptom of impaction because it's the only thing that can get around the impacted stool. It's also a sign of possible obstruction. Both are serious and take very careful treatment. Going poo every 7-10 days will stretch out and cause damage to the colon (although most often temporary damage, but it takes months to heal). As far as the petechiae goes, I have no idea what causes that & what it might be indicative of.



Vomiting is definitely a sign of impaction or obstruction. There is no more room for food or the child's stomach is so tight and crampy, that they're nauseated. When it comes to taking medication, if it can't stay down, you must try another method because it obviously won't work. Even if the child is vomiting on purpose, it STILL WON'T WORK. The pediatrician in this case knows that and is being a lazy ass. (Pardon the explicative - getting on my soapbox here.)



Enemas are good, WHEN THEY WORK, but they are dangerous and dehydrating when used multiple times. Our pediatrician had us give our (then 6-year-old) 3 adult sized enemas (in a row!) before seeing her, but then he was so dehydrated, and that's part of the reason for the hospitalization. The doctor was being LAZY! There is a FABULOUS homemade enema I will share further down this post, but let me tell you about one more serious possibility regarding the issue of chronic, long-term constipation.



There is a condition called Hirschsprung's Disease that some babies are born with. The nerves in the lowest part of the colon are not fully developed, so feeling that urge to go doesn't happen until the child is already backed up or severely constipated. This diagnosis requires surgery to remove the portion of colon without working nerves. There is no other treatment. Testing requires a procedure similar to a colon biopsy. Our son was tested for this, but thankfully does not have it. We saw one of the top pediatric surgeons at the best children's hospital in our state for this testing. You will want a doctor with plenty of experience. They listen and know what you are going through. Here is more info about Hirschsprung's: http://emedicine.medscape.com/article/92...



Now, one of the most useful treatments we've found is a homemade remedy given to me by a pediatrician with lots of experience in the matter - close to retiring age. It's a perfectly safe enema & can be used as frequently as you need to until the hardened stool is out. (However, if your child is fully impacted or if there is an obstruction, the fluid will not have a place to go. This method is good for occasional or severe constipation that is close to the point of emergency care, but not quite there yet.) I LOVE THIS. Here's what you'll need: Castile soap (plain, white, no perfumes - liquid is best, but solid will work), meat tenderizer (yes! - but get it plain without seasonings and such), lubricant (like Vasoline), & an old-fashioned water bottle. Fill a mixing bowl with 1 liter of hot water - specifically, 100 degrees (F). Proper temperature is critical. Add 1 teaspoon of meat tenderizer and 1/2 cup of liquid (or finely shredded) Castile soap. Stir until the the mixture starts to get frothy. Make sure the soap is dissolved all the way & the tenderizer is at least mixed in well. Poor the mixture into the water bottle and place the enema tip on it (it should come with one). Have the child lay on his right side & place the (lubricated!) tip into his/her rectum. (NEVER force an enema tip into the rectum if there is too much pain. This can cause damage!) Allow the mixture to flow in. If it doesn't all go in, it's okay. Try for at least half of it. Let it stay in for 15-20 minutes, 10 minutes at the very least if he/she can hold it. Some people have the child roll to his left side halfway through. Put a towel down in case of leakage. The urge to go usually happens quickly, 5 minutes for our child, but holding it in for at least 10 minutes is important. If you're not successful, you can try again because it's safe!! It works because the warm water relaxes the muscles/colon and helps loosen stool. The meat tenderizer will break down hard stool. The soap makes everything in there slippery, helping it to move on down and out. Again, this has always worked for us and it's safe!



One very important factor is diet. If you are not into the trendy GF/CF diets, that's okay because this is simply about fiber. If your child doesn't eat foods high in fiber, give Metamucil daily. This helps the stool form and move on down. It's very important to also increase fluids. Fiber will harden and cause more problems when there is not enough fluid in the digestive system. So, increased fiber and ample water is essential. (A specialist or nutritionist can tell you the exact amount of fiber your child should have daily. This depends on age and weight.)



The last thing is about aftercare and healing. Your child will need to poo every single day (especially at first) in order for his/her colon to shrink back to normal size. Three months is what my child's specialist told us. He had to have Miralax everyday. After that, he was on stool softeners for many, many months. We also had to add Benefiber at times. Once his colon was a normal size, it couldn't hold such a large mass of hardened stool & the constipation started to go away. He is now 10 and hasn't been impacted since his impaction over 4 years ago. We now maintain with a magnesium supplement and diet high in fiber and water.



*Note: This information is not to be substituted for a visit with your child's doctor or specialist. Please check with his/her doctor in case your child has a condition that requires immediate medical attention.

Susan - posted on 09/18/2012

I second Lisa's advice. It sounds like your son is already dealing with encopresis and can't, or won't, tolerate your doctor's advice. Either way, it really doesn't matter. It's not working, and it's time to try something else. I would definitely see another doctor ASAP. My son's doctor ordered x-rays which showed that his gut was totally impacted. It took more than one med, and a long time to get things fixed. We used Miralax, Senecot (a pill), and even enemas (not fun, but it had to be done). The alternative, as a last resort, is hospitalization for a procedure to clean out all the poop.



Plus, the petechia isn't an ecopresis symptom to the best of my knowledge. I would want to get to the bottom of what's going on with that too.



Find a different doctor as soon as you can, and let us know how things are going. Good luck!

Lisa - posted on 09/18/2012

I just noticed how old this post is. Oops! I hope your son's tummy troubles are better these days. How is he doing? What happened? What did you have to do?

Lisa - posted on 09/18/2012

Get him to a pediatric gastroenterologist right away. If you can't, take him to the ER. He's getting impacted & needs more than OTC meds. This has been a long journey for us, so please trust what I am saying. This situation will require a healing period for his colon after he gets cleaned out. Our son took Miralax everyday for 3 months because it had gotten so stretched out. Keep fighting!

Sandy - posted on 09/17/2012

My son has had constipation issues all his life. He takes Miralax every day as well as a probiotic. ( My Dr suggestion, get the ones the have to keep in the fridge). It is no fun to deal with!

Zaida - posted on 09/07/2012

Yea. Put your son on a GFCF diet (gluten free/casein free). Be prepared for the first couple of days their body will go through withdrawl symptoms but it is worth it. I don't know what to do about night sweats. I heard it is metal in the body.

Zaida - posted on 09/07/2012

Yea. Put your son on a GFCF diet (gluten free/casein free). Be prepared for the first couple of days their body will go through withdrawl symptoms but it is worth it. I don't know what to do about night sweats. I heard it is metal in the body.

Candy - posted on 07/09/2012

Get another opinion. My daughter was dx with Wilms tumor at 8 months old, thought to be constipation. Have someone do a blood pressure, CBC and ultrasound. Watch for blood in urine or stool.

Diane - posted on 05/22/2010

I hightly recommnend you read the "poop page" on the TACA website - lots of tips on helping kids with constipation - www.tacanow.org

Kristen - posted on 05/21/2010

Might be an allergy. How about the Benefiber? I'm glad he's not having to choke down pills.

Kathy - posted on 05/21/2010

MIRALAX!!! When my son needed it, it was RX only, but now is over the counter. You mix it in with a favorite drink and it has no taste. It is very safe and works without side effects!!! You may need a big dosage to get things going, but after that, a little daily WILL work.

Amber - posted on 05/20/2010

Miralax is what was making him throw up. Milk of magnesia did not help at all. The Docs put him on Miralax again just 1 oz every 2 hours. So far he has not thrown up from it and he started ti 20 hours ago. I'm going to try it for a couple weeks and see if it helps. He is supposed to get another xray in 2 weeks, don't know if I want to let him get another one if he seems to be doing better.

Kristen - posted on 05/20/2010

Are the stool softeners pills that he takes? Milk of Magnesia is kind of gross-tasting also. Your child might just have a strong gag reflex. It's hard for kids to learn how to swallow pills, too. Also, the vomiting may just be a sign that he is allergic to the medication. My sons (one PDD, one not) both have constipation issues. They have done well on Miralax and Benefiber. Miralax is a little stronger, so I'd try the Benefiber first. They are both clear powders that you can mix with juice or kool-aid or whatever. I wouldn't mix it just with water, as it tastes slightly salty. Otherwise, you can't taste it. I also curb milk products and chocolate in my children's diets. My older son likes Activia also, so you could also use that. He eats one a day.

I've heard that most kids on the spectrum have either diarrhea or constipation issues. I would like to know if there is anyone out there who has a child who doesn't.

Britt - posted on 05/20/2010

We also make sure our two youngest children take Pro-Immune Support capsules daily---filed with probiotics. (Kirkman Labs) They also take a Coromega packet daily.....

Britt - posted on 05/20/2010

My oldest daughter--now 8 years old-- is dx with ASD w/Mixed Dev. Delays....started 'holding her poop' (encopresis) when she was being potty trained, at around the age of 3-4 years old. Our develpmental pediatrician gave us a referral for our daughter to see a pediatric gastroenterolgist.....our daughter takes Miralax as needed in whatever liquid she wants to take it in....it dissolves & is suppose to be odorless & tasteless....though our daughter has a very strong sense of smell......anyway, it works. HTH!

Mimi - posted on 05/19/2010

Change Doctors! We have been going through this and still are. He goes about once a week, stomach hurting, strange poop, etc. We have been trying high doses of vitamin c and George's Aloe Vera Juice. Find a Doctor who understands. I found a Doctor whose son is Autistic and it has made all the difference in the world. I don't have to explain things to her, she gets it.

Erin - posted on 05/19/2010

Go to your nearest health food store and by probiotics for children. It has been a life saver for my 4yr old son. Give it to him twice a day(about 1 tsp.) during his daily meals. Also, I've just come across a fruit smoothie drink called Odwalla superfood with Omega 3 from flaxseed. that has made my son who was so constipated, going 1 time every two weeks, going every other day. Stop listening to that doctor, stop giving him that stool softener. and take matters into your own hands. Feed him lots of food rich in fiber. Strawberries are loaded with fiber and lots of other benefits. Good luck

Tiffany - posted on 05/19/2010

hunny been there , tell the doctor you want him prescribing movicol, it is the only thing that works for my lads, it is powder you mix with water and they drink doesnt taste nasty, normal does 1 - 2 a day but to begin with you can give 4 times aday untill he goes , does cause belly ache or cramps , was recommended to me by the incontience nurse at work , i am a staff nurse have never looked back prior to this my eldest had to have picolax and that is horriable for every one
hope this helps keep your chin up here if you need me Tiffany xxx

Jeanette - posted on 05/19/2010

my daughter had this for about 2 yrs.we put her on mineral oil ,it worked it got to the point were her intestines telescoped out ,get a new dr. your his mother you know your kid ,dont doubt your gut feelings ,dr.see so many people everyday they dont realize the stress of something like this .to watch your child suffer day after day is hard for you and him.be very frank ith your dr. tell him your stress and if he wont help find someone that will.our dr.didnt take it as anything tilll he intestines came out then they ran test and talked surgery .i know your stress your not alone . hope al goes well listen to your little voice and trust your gut

Pine - posted on 05/19/2010

Probably see a specialist. But you might want to try Miralax for now. If your DC has had a lot of straining and painfulness it may take him awhile to realize to relax and actually let the BM happen naturally (with help from Miralax). But the specialist could rule out other issues.

Helen - posted on 05/18/2010

I'm sorry to hear of your childs discomfort, it must be a very frustrating situation with the doc etc. My son and I have been through a similar situation and found a dose of Parachoc in a milkshake helped him when he needed it. I'm sure there are many diff products, but some children just don't like them. I also know its hard sometimes to change their diet. Does your child eat lots of fruit? As I know vegetables can be a hard ask. Not just that, sometimes there could be an underlying problem with your childs bowl? It may pay to ask your doc about getting an ultra sound or x ray or whatever they do for the bowl, to make sure everything is in order down there. Another possibility may be with the sore tummy and the other symptoms you have mentioned,that it may have something to do with a gluten intolerance. I'm no expert, just hoping to put forward a few ideas that may help you in the relief of your childs problem. I hope you find a solution as soon as you can. Goodluck.

Shasta - posted on 05/17/2010

two of my three have the cycle of constipation/diahrrea. if your doctor won't help, ask for a referal to a specialist. what we found out with my oldest is that he doesn't like the feeling of going and would hold it (the constipation) until he just couldn't (diahrrea). he now has a behavioral therapist working together with an ot to help him. my youngest doesn't seem to show any signs of it being a sensory issue. we are working with a gastrointerologist to track his specific issue. hope some of this helps. :)

Cathy - posted on 05/17/2010

the juice from stewing apples is the best remedy. don't add any sugar, just a splash of water and let the apples stew. strain and it's fine, Aboriginal women taught me this remedy, it really works.

Amber - posted on 05/16/2010

Thanks Every one you have been very helpfull. I went and got a second opinion, hope stuff works out.

Deanna - posted on 05/15/2010

This is a home remedy i done with my son and it worked try putting a Tablespoon of dark karo syrup in his cup of milk and if you need to adjust the amount but it worked for my son also go to your pharmacy and ask for Fletcher's castorea it is a liquid .

Wendy - posted on 05/14/2010

My son was on meds for chronic constipation for ten years, the medicine he was given at first he could not hold down, I went back to doctors and had it changed to tablets, initialy he was on sennacot syrup (disgusting) then tablets, then he ended up under hospital consultant and was given sodium picosulphate medicine (not nice) but he was very god at taking it untill recently, he is now 16. this can be a very serious life threatening condition, please change your doctor if he is not sympathetic towards your child and his condion. it gets better evenually but usually only when the child reaches adolesent or adulthood. I was told he would be on medication for a couple of years. He had soiling problems for many years because of his constipation. Good luck, remember you know your child better than the doctor so do not be fobbed off. chronic constipation over years untreated can be fatal, I don't want to scare you but it is a very serious condition which I believe is linked to aspergers

Susan - posted on 05/14/2010

Just a word of caution: Don't wait! If constipation goes on too long it develops into encopresis. Basically, the retained stool stretches out the intestinal muscles to the point that they're too thin to work properly, and then the child doesn't have bowel control until you can get the constipation resolved for long enough to let the intestinal walls recover--which takes months. Meanwhile, you're dealing with regular poop accidents due to the leakage, and you wind up having to redo potty training. We've been through this with two of our kids, and both times, they were about 12yo before we managed to get to the point where they were cured. I hope you can get your child treated before things get to that point, because it is absolutely the most frustrating thing--and very bad for their self-esteem. Good luck!

Sherry - posted on 05/13/2010

My daughter would only go once every 4-5 days until we experienced her not going for 14 days. I ended up taking her to a pediatric gastroenterologist who perscribed a mixture of miralax, fiber, and probiotics. Finally she is on a regimen that she goes almost every day. I would recommend going to a specialist first and have them monitor your progress until you too are on a regimen. My daughter was 8 when this happened.

Amber - posted on 05/13/2010

Thank you! we do not have any child stomach specialists in my area but I think I'm going to call one out of state its only a 6 hour drive and I think it will be worth it. I just feel so sorry for my little guy.

Krista - posted on 05/12/2010

this is a horrible thing foe a child to go through.i would change doctors for sure he is not listening or offering you anythingelse, there are so many different products on the market for children with this thing that i am sure you will find one that suits you both, i found that yes it was a bit costly at first trying different ones and having to throw them out but in the long run it will be better for your child when you find the one that works as i found he will continue to have this every now and then for a few years i used coloxyl for my daughter and you can mix it with milk as long as they drink the whole lot.if you find nothing is still working i would tell the doctor dont ask, that you want a referell for a pedetritian.