I’m new - 5 yo problems got worse since she started school

[Klew83]

My 5 year old has been for a poo once in 2 weeks, last Friday I started using lactolose as she hadn’t been for nearly a week. Complaining feeling sick, bloated stomach, gas. She finally had a poo Saturday but since then nothing. I’ve upped dosage to 10ml twice a day since Sunday but still no luck. She normally goes every day but since starting school in September it’s slowly got worse. I apologise cos I know some of you have had problems for years. I’m at my wits end because I’m trying to deal with this at same time as losing my mum last week so my emotions are heightened. My plan is to call GP on Thursday again (as she only works PT). Any advice appreciated thank you x

[SallyCal]

Hello, sorry to hear of your loss and I can totally understand how you are feeling with your daughter. My daughter had problems withholding her poo before she started school and we thought we had resolved it ourselves with diet changes and extra water but it also got much worse nce she started at school. I found she didn't drink much even though she had a bottle of water everyday and eating school dinners played with her diet. Speak to the school and let them know as bowel and bladder problems are so common in children I am sure they will understand and be able to keep an eye on her water intake for you. My daughter's school gave her reward points for drinking her water bottle by lunchtime. I would also speak to your GP. We used Lactulose at first but it was only when we got a Macrogel that things improved. So they might suggest switching to that instead. Have you asked her why she isn't going? Our daughters problems came after a constipation episode when it hurt her to go and she got scared to poo so held it in but that just made it worse as when she did go it was hard and big and hurt again. It became a very big vicious circle and we tried to solve it ourselves for over a year so please don't wait as long as we did. Speak to your GP. Xx

[Klew83 in reply to SallyCal]

Thank you. Yes I have spoken to the school but I think reward chart does sound like a good idea. At home I can keep reminding her but many times she comes home and water bottle is untouched. I’m going to speak to the doctor tomorrow as she is aware of history so I will ask about the other medicine. Thank you for your help xx

[Donners1 in reply to Klew83]

I have struggled with this with my 6 year old for many years. I have finally got her routine sorted and got her to go regularly but I don’t know how long it will last!

She has Movicol paediatric drink once a day and we just load her up with lots of fruit at every meal and get her to drink lots.

I also spoke to the school and they let her take in diluted apple juice which our doctor said should help make her regular.

With my daughter it was all psychological and, as the previous person said, a vicious circle. She held it in once and then it starts to hurt so she kept holding it in. And it’s so stressful as they lose appetite, have no energy and they’re just not themselves. I really feel for you

We have been to the doctor and even the hospital and they just told me to up the movicol and get her to eat lots of fibre.

This is going to sound odd but I find the best time to get my daughter to poo is when she desperately needs a wee. Sometimes I even get her up in the middle of the night when she’s at her most relaxed and put her on the toilet for a wee and sometimes a poo comes too. I also put lots of her toys in the bathroom when she’s on the toilet and stay with her to keep her company so that she can be as relaxed as possible!

Anyway, I hope some of this helps. This has been the Bain of my life for some time so I feel your pain. Good luck! X

[Klew83 in reply to Donners1]

Thank you so much for your advice xx

[Helen36]

Hello - what a tough time for all of you. I suggest having a really good look on the ERIC website about constipation and withholding in children and the pinned posts on here from the poo nurses. Not going for two weeks means there will likely be a huge build up in her tummy (more than just what came out at the weekend) and she almost certainly needs a disimpaction with Movicol or a similar macrogrel that softens the poo in her tummy so she can pass it. It will just continue to be loaded in her tummy and stretching her bowel until it is fully cleared out. After that she might need a stimulant like senakot rather than lactulose to help the bowel muscles push the poo through.

There’s lots of information on the website about routines that will help her too. Sitting on the toilet and trying to blow a balloon or windmill about 20 minutes after every meal is critical to helping a child that withholds and is your best chance of helping her get poo out. Everyone has a reflex after eating that means this is when the urge to poo is likely to come and blowing something engages the right muscles. I’d also recommend a book called ‘meet the poos’ which is all about a family of poos that want to play in the toilet flumes and helps you talk about poos with her and massively helped us overcome withholding behaviours. I’d also suggest asking the GP if you can be referred to a continence nursing team (not all local areas have one and waiting lists are long) but this will be your best chance of getting specialist advice.

My other idea is to talk to school about whether she could go for a try for a poo in a private or disabled toilet after lunch or any other time she wants. The fact it’s been since September makes me think she’s probably shy about going at school and holding it in, then it hurts, so she holds some more... vicious circle as everyone describes.

And finally - start recording everything. Any soiling, time and date of poos, what they look like, colour (pale/dark), smell, girth (frankfurter, sausage, banana) loose etc. Information is power with getting this sorted quickly.

If you are left feeling like you haven’t got anywhere after the GP appt tomorrow, ERIC has a helpline which is really great.

Good luck and everyone here will help you xxxxx

[Klew83 in reply to Helen36]

Thank you for your advice xx

[Trascal]

Hi I’ve been there with my daughter who is now 7! She did a sore poo during toilet training when she was 3 and I had 4 years of soiling and holding in her poos, she was on lactulose twice a day. Fingers crossed we are nearing the end of this now she still occasionally needs lactulose when she gets constipated but here are some of the things we have done to improve the soiling, appreciate every child is different so what might work for one won’t work for another but if it helps another family improve the toilet/soiling situation it can only be a good thing!

1) see your GP to let them know of the soiling situation and get some medication to soften the poo - we were on lactulose twice a day 10ml - ask to be referred to a child constipation clinic at your local hospital - we had a 4 month wait but was really good to get some advice from a consultant who knew what they were talking about rather than my gp. I also kept a diary of when she done a poo or soiled her pants to take to gp appointments

2) establish a toilet routine! We were guilty in my house of rushing for work/school/social events so now we get up earlier so my daughter has plenty time to use the toilet after breakfast and does not feel rushed - an article from the ERIC website helped me get a routine going with my daughter. We also make sure that she goes to the toilet after dinner too! we call it “toilet time” I’m strict with the routine to the point now my daughter tells me it’s toilet time after breakfast or dinner! If she hasn’t been for a poo in a couple of days I sometimes do a lunchtime toilet routine at the weekends when she is not at school!

3) find out what gets your child to sit on the toilet for 5-10mins for toilet time - ours started with colouring in, reading, I stayed with my daughter initially to build up her confidence and showed her that it was ok to sit on the toilet! We used to have fun together and play games so she would get distracted and do a poo without noticing. She now wants to be in the toilet on her own so we now let her use a kindle but we limit the usage on it and try and keep it to toilet time - she will quite happily sit there for a longer period with the kindle

4) reward for completing toilet time - normally a sticker on a reward chart does it in our house regardless whether she has done anything and if my daughter does do a poo I give her a penny which she saves up to buy something with

5) we provide my daughter with a footstool and padded toilet seat (Disney frozen theme) this has helped her sit properly and find it easier to do a poo

6) diet - we start the day off with a fruit smoothie consultant said this was good for keeping the poo soft! Rest of the day I try and give my daughter food with a good fibre content and cut right back on dairy! She only has milk with cereal (weetabix), I buy 50/50 pasta so she can’t see the wholewheat, popcorn for snacks (quite high in fibre) and loads of water to drink

7) fluids - my daughter has never been the best at drinking fluids but we have competitions at the dinner table to see who can finish their glass of water first - works every time as she doesn’t want to lose so will drink all the water

8) we leave the car at home whenever we can and walk, go to the park, swimming etc to make sure she has plenty exercise to get the bowels going

I’ve read the book recommended on here called the in’s and out’s of poop! Would definitely recommend it my daughter had been soiling for so long I think she had forgotten how to push a poo out the book helped with some wee techniques to get her going - I also discovered that a party blower or blowing up a balloon on the toilet has helped too to get the pushing situation going again!

I hope the points I’ve listed above help it’s only when you start talking about it you realise what a common problem it is!