Withholding

[Cmcmap]

Hello, my 3 year old daughter has suffered with constipation since she was a baby. She is now on laxatives daily and her poo is soft but she withholds. I am finding it so hard to deal with. Other people don’t understand how stressful it is and think she is just bein naughty. I can’t sleep as I am so worried about her. We are on day 7 of her not going and she is so grumpy and not sleeping either, she must be in a lot of pain. We have tried everything and I just don’t know how to help her! Any advice would be gratefully received. Thank you

[SallyCal]

I'm not sure I can offer any good advice if you are already on medication but just wanted to let you know you are not alone and that we are all here for you. My daughter withheld between ages 4 and 5 and it ruled our life. I dreaded her needing a poo because it was a traumatic experience and it impacted every part of day to day life. She got very grumpy, wouldn't eat or have a bath. Hers started from a bad constipation episode where it hurt and she then got scared to poo so would hold i tin which just made it bigger and harder so it would hurt again. We tried increasing water, fibrous foods, reward charts, toilet toys but the only real thing to make a difference was Movicol/Laxido. Once she could go and the poo be soft enough that it didn't hurt she started to turn a corner. She is nearly six now and we are still on a maintenance dose but I don't worry about it at all now. Do you know why she started to withhold? Is she still on laxatives now? The poo nurses video is really good and I found the ERIC helpline great to. Xx

[Cmcmap in reply to SallyCal]

Hello, thank you so much! Yes she has been on Movicol since June and to start she did go on a potty every other day but she just stopped and won’t go. She was constipated as a baby due to reflux medication and it has never really got any better. When she does go it is soft since the Movicol started working so I think it must be psychological now and I just don’t know how to help her. Thank you it’s good to hear of children overcoming it x

[Nanoiu]

You got to start using enemas! That’s the answer. Are you just seeing a GP? A GP won’t prescribe it probably, they just know about laxatives, so you need to ask to be referred to a paediatrician or gastro specialist.

For the older kids, they recommend establishing a toileting routine to overcome witholding behaviour but that works with older kids - is she in nappies, by the way??

Using enemas Is the only guaranteed way to empty the rectum on a regular basis. One can’t fight the urge to poo when given an enema.

Google on the topic of enemas and constipation to find out more.

You can buy them over the counter until you get it by prescription.

We used 5ml disposable enema for a 5 year old but my friend used it for her 3 year old (on prescription by a paediatrician). For months, on a daily basis.

You could try to melt the poo with a very large dose of laxative, but it would be very hard to administer such a high dose of laxative to a 3 year old on a daily basis.

[Nanoiu in reply to Nanoiu]

Sorry, just noticed your second post. Does she always withhold for several days? Does she soil? How much Movicol was she prescribed? Have you ever been prescribed a stimulant in addition to the softener (Movicol)?

[Cmcmap in reply to Nanoiu]

Hello sorry for the late reply been back to the doctors with her today. She is on two Movicol a day. We are going back Friday for a review. They have just told us to try the usual putting her on the toilet after each meal and at regular times. Not that easy as she is now terrified of it. They want us to give her an extra Movicol in the afternoons for the next few days and hope there will be movement before we go back Friday. They will review then and decide best next steps. She used to soil but has started managing it now and hasn’t soiled for a few months. I think this may change with the extra Movicol she is now having. She isn’t in nappy’s and we struggle to get her in them as she has a baby sister and she doesn’t want to be a baby! If she starts smiling again I think she may accept a nappy. I have looked at enimas and will speak to doctor when we go back Friday thank you. My only worry is we used suppositories a couple of times and she was terrified and wouldn’t let us near her, she was shaking and I thought this may have made the situation even worse? Thank you so much for your advice we will try anything and so good to hear stories with good outcomes!

[Nanoiu in reply to Cmcmap]

Sorry, you are right, the enema may frighten her. When my son started soiling, he was 4, and we administered a couple of enemas bought over the counter at the chemist. After that he wouldn’t let us near his bum until he was about 5 and a half. By then, he could be bribed, he understood the concept of money and wanted some. I gave him $20 for the 1st enema, and he let me do it and realised it wasn’t that unpleasant after all. In time , I gave him less and less reward. Once he noticed the enema makes the soiling stop, he didn’t mind it.

But at 4, you couldn’t reason, negotiate or bribe him. I remember now what a pain it was to get him to drink half of a Movicol sachet, which was too little to soften the poo!

I wonder how my friend managed to give the enema to her 3 year old son!?! I know she did it for months after seeing the gastro specialist.

So that only leaves the stimulant as an option, senna, as far as I know.

Another thing to remember is that an enema can only clean out the rectum. If the impact ion is higher up in the colon, it won’t reach it.

[Cmcmap in reply to Nanoiu]

Thank you so much for all the advice. We are seeing the doctor again tomorrow. We did get one poo two days ago, we have doubled Movicol and she is desperate to go now but she just won’t. I think stimulant May be the way to go now. I have just read a book called Stool Withholding and it has helped me understand much more about it. We have started on the routine of sitting on the potty at the same time each day and after meals. She isn’t happy about it but we are only a few days in so fingers crossed we will establish a routine. I feel so much better now just know I g we are starting treatment x

[Sam2020]

Just wanted to share my 3 year old son is the same with his withholding. He’s so full and bloated and has been running round and holding all evening. He woke so many times last night in pain. He’s such a wonderful child and it breaks my heart as don’t know how to help him. It is purely psychological now. Paediatrician has prescribed senna. I hope we can break this cycle of withholding. The poo is soft and has been for a long time.

[Cmcmap in reply to Sam2020]

Thank you for sharing. It sounds like your son is in exactly the same place as my daughter. It is heartbreaking and I hate seeing her in the state. My daughter poo is also soft now and just need to work on her Psychologically. Fingers crossed we get both our children on the mend soon x

[Sam2020 in reply to Cmcmap]

I hope we get there too. Do post and update how things go.

Just to let you know. We’re trying the following:

- a twice daily 10 mins toilet sit 20 mins after breakfast and dinner (to be honest I find he withholds more since we introduced this but we’re persevering)

- praise for just sitting (not asking to do anything else) nurse said he could feel like he’s failed so give him something he can do, like simply sit on loo

- sticker chart

- trying to take a break from talking about poo

I’m hoping the senna will break the cycle for us though. Will let you know. If you find anything that helps let me know x

[Cmcmap in reply to Sam2020]

Of course and please keep me updated on how you are getting on. We are doing exactly the same with the toilet sits and not pushing for a poo, reward chart and trying not to talk about it too much. We are only day 2 now so very early days. Finding it hard to get her to sit without getting upset and she wiggles about so much with the pressure I guess but we will keep going and hope we get there. Good luck x

[Sam2020 in reply to Cmcmap]

I know it’s not ideal but best success we’ve had is using iPad while he sits. He’ll happily sit then. Also can give him some privacy as heard this can be important although he hasn’t always wanted privacy.

[Cmcmap in reply to Sam2020]

We finally had another poo tonight! She was in so much pain it’s such a relief but I had to fight to get her in the potty. She won’t accept a nappy but is terrified to sit on the potty it’s heartbreaking. Just hoping by establishing a routine she might settle!

[Sam2020 in reply to Cmcmap]

That’s great news! So happy she finally done one! My son finally passed one in his pulls ups and then passed out on the floor he was so tired. He sits on toilet which makes me think he’s not scared of it, but holds it the whole time and will only do it in pulls up....

[Cmcmap in reply to Sam2020]

My daughter was like that a few weeks ago bit she won’t accept a pull up but screams about sitting on the potty or toilet when it’s getting close to her needing to go. She is so happy this morning, like a different child. It must be such a relief for them! Hope you have a good day with your little boy and fingers crossed they both manage to go again in the next few days x

[Sam2020 in reply to Cmcmap]

Yes they are so much happier once the poo is out! Can’t imagine how they feel holding it in all the time. Wanted to let you know our local nursery nurse suggested syrup if figs. Two tsps a day. We’ve left laxido the same and not started senna yet and we’re having some success with it. He’s gone today and yesterday! We’ve been doing more exercise too, but just wanted to mention the syrup of figs in case it helps you too.

[Cmcmap in reply to Sam2020]

Thank you we actually we told to try that last week too. My little girl went two days in a row then didn’t yesterday but obviously ended too and she wet the bed overnight which really upset her. Today she went with no arguments so really hoping we are starting to establish a routine. Thank you always happy to try any recommendations xx

[Sam2020 in reply to Cmcmap]

That’s fantastic if she went with no arguments! That’s great progress. I’m hoping my one starts to go regularly and once he’s doing that, we can then get him to use the toilet...

[Cmcmap in reply to Sam2020]

Yes that’s right I don’t mind where she goes as long as she goes at the moment and once she is regular we will worry about toilet/potty/nappies! Fingers crossed we are both in the way to getting our little ones regular! Great progress they have both gone a few times in the last week or so x

[Sam2020 in reply to Cmcmap]

Yes so grateful! It also means he’s eating more too now!

[Sam2020 in reply to Cmcmap]

How are things going? We’re not doing too good...