Newbie - Need help!

[Nikki_1985]

So my 3 year old daughter has been withholding her poo for about 14 months now. I'm not entirely sure what caused it to start, probably the potty we bought her for her 2nd birthday (not that we started toilet training), but it definitely wasn't constipation.

Various trips to the gp have done little to help, Movicol being prescribed first but was taken off it after an explosion that resulted in me throwing away 2 whole outfits! (Doc said this was not the desired result, but half a sachet less and she was still able to hold it in)

I've tried baked beans, lots of praise, sticker charts, ignoring the whole poo subject altogether, olive oil, diet changes, etc and nothing seems to work - she is so strong willed!

Then I had 2 very stressful nights a couple of weeks ago where she was waking up in the middle of the night screaming and crying because she needed to go but really didn't want to! It was almost as if she was saying "mummy I can't live like this anymore, help me!"

I'm lucky if I get a a solid lump once a week, most of the time she just soils her nappy. It's a viscous cycle because she's held it for so long that it does hurt when she passes a lump now, because it's so large.

I stumbled across the Eric website and have taken her back to the gp and she's now on sennakot syrup. She needs a "clear out" which the sennakot will do but I'm a little unclear as to when to know she's clear. The Eric website says "brown water".

She's currently on 5 tsps at bedtime and I'm getting what I would call diarrhoea - it still has some substance to it and is not watery (sorry TMI!)

Do I keep her at 5tsps until this is achieved? Or do I continue to up the dose gradually?

If you can help, many thanks in advance. I just want my little girl to feel better

[Georgina1475]

It would be a guess as not used that medicine but I would keep going. I've only used Movical for clear outs.

Any amount of things could have caused her to start so don't concern yourself with what it was, we end up tying ourselves in knots asking what we did?? When really it's nothing we've done it's just one of those things.

At least she's on meds now but I would keep in touch with he GP ask for a referral to the Incontinence service (if you've got one) she will need maintence meds while her body readjusts to going more often and they are more knowledgable in my experience.

I found it's best to keep nappy creaming the bottom while on clear out as it can be acidic and cause soars.

Best wishes that it won't be too long.

[Nikki_1985 in reply to Georgina1475]

Thank you so much for your reply!

I will keep going then. I think I'll go back to the gp when we've had the clear out to see what's next and ask about the incontinence service.

A 10 minute appointment at the doctors is probably not long enough for them to tell us in detail everything that needs to be done from start to finish.

The silver lining for me at this stage is the change in her temperament - I already feel like I have my happy little girl back. Let's hope that the only way is up from here!

[Georgina1475 in reply to Nikki_1985]

My son acts out and can't rest when he even slightly bunged up so I can imagine what it's been like for you and your little one. Plenty of cuddles is what's needed for you both now.

I also look up tummy massage techniques for after bath time as this helped my son also "poo goes to Pooland" is a good book for when you're ready to talk about toileting again.

Best wishes G

[Nikki_1985]

Update!

Just had the "brown water" effect I was hoping for - I'm so happy!

It's taken one week total to clear her out completely! I wish I had found this information a year ago, it would have saved a lot of tears, tantrums and hair dye (and that's just me!)

[SallyandPaul in reply to Nikki_1985]

Well done you're doing all the right things. It will take a long time for the sensitivity to come back because her bowel will have been so stretched . Our daughter has been on movicol for four years and it's only just beginning to come back now. I am reducing her movicol ( we give her one sachet a day) by one teaspoon every few weeks . It's terrible stuff to get the correct dosage. If you get time watch the you tube video by a nurse Sandra Hanson on tackling constipation and soiling . Good luck x

[Nikki_1985 in reply to SallyandPaul]

Thank you, I'll definitely check that out tonight. Just had a telephone appointment with the gp who said to halve the dose tonight, down to 2 1/2 tsps. Does this sound right to you?

I find it's very much "playing it by ear" because every child is different, but I really don't want to go back to square one, not after such a successful week of clearing her out. But I don't want to over medicate her either.

[SallyandPaul in reply to SallyandPaul]

I would think so I imagine that five teaspoons is quite a lot. Like Georgina we've only used movicol for dis impacting. A cosultant did prescribe 1 movicol with half a teaspoon of senokot but only for a little while but not for the dis impacting . He then told us to go down to half a sachet of movicol but that wasn't enough and a whole one can sometimes be too much!! You can't win but as you say any things better than them coping with the pain of trying to pass a huge stool !! X

[Nikki_1985 in reply to SallyandPaul]

Ok thank you. Well we'll see what I am greeted with in the morning, if anything, and go from there I guess.

Like I said before, I just don't want to go back to square one. We've been battling this for too long now. I know that some parents have had it go on much longer than I have, but I'm perhaps not as strong as they are.

[SallyandPaul in reply to Nikki_1985]

No you definitely don't want to go backwards and don't worry you're doing great. It is a frustrating unpleasant situation but you'll get there. Take care

[Georgina1475]

It really is playing it by ear but you'll soon get used to what works best for your little one when to take it down and when to add a little more.

[Hidden]

plums, peaches, pears, a nice large green salad....all of these still work wonderfully well. Frozen or tinned when not in season.

[Nikki_1985 in reply to Hidden]

Yeah we do all of that anyway. I tend to stick to "p" foods when her appetite isn't great.

But so far going well, we're down to half a teaspoon of sennakot syrup every day and she is much more comfortable. Going every other day with type 4 on the Bristol scale. I couldn't be happier

[Nikki_1985]

Update!!!

We've had to up the dose to 1 tsp as she has started to withhold again. I wish she would just understand that going for number 2 is normal and it won't hurt if you don't hold it in! It's just not a concept that she gets at the moment. I can only hope that we don't get to the place we did with movicol - half a sachet difference between being able to hold it in and diarrhoea.

I am so frustrated it's unbelievable. I don't know how you all cope. So hats off to all of you who have been going through this! It really has been the hardest part of parenting for me by far!

[FranAdam in reply to Nikki_1985]

Senna is great for pushing poo out but it is not a stool softener. With children who withhold it is often fear it will hurt. Can you ask your GP for some Movicol which is a stool softener, NICE guidance advise it is used alongside Senna to get soft poo that is easy to push out. Also try getting her to pass stool in the bath, not nice for you but it will hurt less and reduce the fear. Also blowing bubbles on the loo helps relax the anal sphincter.

[Nikki_1985 in reply to FranAdam]

Thank you for the reply.

We were given movicol at the start of this drama but the doctor took her off it as it wasn't working in the way they hoped!

We were told that it was a control issue, whereby DD was deliberately withholding and that she would grow out of it. Fast forward a year and we're still no better.

I let her go wherever she wants to as I feel it's better out than in, but still no joy. Tried blowing bubbles and even a recorder in the hope that it would distract her enough to relax and let go, but she won't let me in the same room as her when she's trying to hold.

I know she's drinking enough and not having many binding foods. Doctors even suggested baked beans every day and now, DD no longer likes baked beans!

The truth is, that her poo isn't hard, until she's been holding in for so long (9 days the last time). I just need her not to be able to hold, which is why the doctor suggested the sennakot, but getting the dose right is tricky!

I'm fully open to all options though so anymore suggestions are greatly appreciated!