5 year old, no longer constipated, but is scared to poo and withholds it

[Yael_Ro]

Hello all. Our 5 year old son was constipated 10 days ago but we gave him movicol and suppositories and got all the backlog out. However, he is now refusing to let his soft poo come out. He is shouting from pain and is in a very bad mood and is unpleasant to be with (very different from his regular character). He says that he is scared of it. We give him 3 movicols and Sodium picosulfate or mineral oil.

When he was 3 years old, he was withholding his poo for a while but it stopped after a few months and he was pooing without a problem in the toilet since then.

I do not want to let the poo issue dictate our family life but we can't really do much because he is so upset and in so much pain.

What I don't know is how will he ever overcome this fear and what should be our strategy about helping him without driving all of us insane with stress.

[SallyCal]

Hello, my daughter withheld for over a year following a constipation episode at the age of 4 and behaved in exactly the ways you described. It is a vicious circle because if they hold there poo it gets bigger and harder and then it hurts them to go reinforcing their fear (even if you think the poo looks soft I found aswell). You have to break that cycle. We tried to manage it with an increase in water intake and high fibre foods and using techniques to establish a good toilet routine (sitting regularly, toilet toys, reward charts). We tried this for far to long in hindsight and the only thing that worked for us was a regular dose of Movicol and I just wished I had done that sooner as it did rule our lives for far to long. You need to keep the poo really soft to break the withholding cycle so a relatively high dose at first, we were lucky and never had to do a disimpaction but got to the cow pat stage of poo. We then slowly reduced the dose until the poo had shape but was still very soft so we could ask her if it hurt when she went and make a big thing of it when she said it didn't. We then kept slowly reducing the dose every couple of months until after about a year she was on 1 sachet every other day and eventually we stopped it completely. Every child will be different so you will have to find the right dose for them. Best of luck and let me know how you get on. Xx

[Yael_Ro in reply to SallyCal]

Thanks Sallycal for your response. But my son is so terrified that he holds in poo despite a lot of movicol and other things. What did you do in order to get him sit on the toilet? My son is screaming from pain but doesn't let it come out.

It makes me so anxious and consumed with this.

[SallyCal in reply to Yael_Ro]

My daughter was the same but did eventually go once every 3/4 days but it made her very upset and the poo often got stuck reinforcing the fear. Does your son go at all? We couldn't get our daughter to sit as she is very stubborn and we tried reward charts, toilet toys, even bought her a tablet just to use when sitting but she even held whilst sitting! So the only way was to make the poo come out for us with high doses of Movicol. For me I knew it was just fear and if I could get her to go without hurting then she would start to break the cycle. It took a while but we just maintained the high doses and very slowly reduced it down. Is your son on Movicol still now? Xx

[Yael_Ro in reply to SallyCal]

He is on movicol and sodium picosulfate but he still holds it in. He started withholding 10 days ago (so I know it is recent and that i am overreacting) and went 3 times but with a lot of shouting and pain.

We are starting today to get him to sit for 5 mins in the morning and afternoon regardless of the productivity.

I wish I could be less worried as it is not helpful.

[SallyCal in reply to Yael_Ro]

Your not overreacting and I wish I hadn't left my daughter's withholding so long so you are doing the right thing trying to resolve it quickly. The book Kejade mentions sounds great and I wish I had known about that when we were going through our situation. I really hope you all turn a corner soon. With regards to getting into a good sitting routine they do recommend trying about 30 minutes after eating as it is when your body naturally wants to push! Xx

[dharshana in reply to SallyCal]

totally for how many months your daughter was on laxative? can you please share your success story please

[Hidden]

Hello. I feel your pain, my daughter did exactly the same thing and it was the most stressful thing ever. I used to find her hiding behind doors, red faced and crying in pain while she desperately tried to hold her poo in. She was absolutely terrified of pooing because she was so convinced it would hurt, even when her poo was soft. It was awful and it did dictate our lives for a long time. Unfortunately, doctors don't seem to really understand this issue- it's a psychological fear but my doctor always thought it was physiological. It wasn't. The problem with this issue is that, as the sphincter is a muscle, the more they hold it, the better they become at it! My daughter was able to hold for days and days on end. I tried everything. In the end I found a book on Amazon, which really helped. It's called "stool withholding. What to do when your child won't poo". By Sophia J Ferguson. I followed the Movicol programme (but adapted it a bit for my daughter). It's quite lengthy but it did work. I'm so happy to say that my daughter is now 6 and she hasn't poo held for about a year, give or take the odd blip. I did loads of research before I did it because I was worried about the levels and duration of using Movicol, but it was no problem and it's safe. Basically it works on making the poo so soft that even the most hardcore of sphincters can't hold it in. Gradually they learn that it is not a scary experience to poo. If you want to talk about it more, please feel free. It was such a difficult time for us and no-one really understood. Good luck. Kerry. X

[Yael_Ro in reply to Hidden]

Thanks a lot for this and for the offer to chat more which I appreciate a lot.

Was there anything that you said to her which helped? Does she talk about it now?

[Hidden in reply to Yael_Ro]

I asked her today whether she remembers what it felt like and why she was scared to go. She said that she remembers being scared that it would hurt. She said she also remembers (aged 3) being poorly when we went to Spain (she had held for four days prior to our holiday and as we got to the airport, she doubled over, screaming in pain. I was on the phone to my doctor as we were going through customs as I was panicking about whether to get on the flight or go to A&E! On that occasion, she did a wee and it freed up a little bit of space in her abdomen) That's when I put her on the Movicol programme from the book I mentioned. At the time, I was just always trying to reassure her that she would be ok, but it was hard to get through her fear. As I say, in the end we broke it by getting her to the point that her poo was so soft (almost runny!) that she couldn't hold it even if she wanted to. She learned that she couldn't hold it and eventually she moved on, though she remained on one daily Movicol sachet for a further whole year. I'm so glad it's over, but have faith because it can be managed. You are right to be tackling it straight away because if it becomes a habit it can carry on right through to teenage years.

[Sobia15parveen in reply to Hidden]

Hi dear can you help me

[Emily-vb]

Good on you for taking it so early! Have you solved the issue?

If in need of more stories, i second the high dose of movicol and I add running to it. My little girl is 3 and we live next to a wood, so we did lots of races and hide and seek, eventually she just had to go. The exercise helps push the poo out. She pooed in that wood quite a lot - she was in nappy mind you... and then to potty train (on that one we came from far) I bribed her with lollypops - please don’t judge me - and sitting on the toilet helped her go - put her knees higher too.

I hope he is ok xxx

[ClaraB1]

Hi I'm writing this after a terrible week of my 5 year old son complaining in pain. He has been withholding his stools since starting school last September although in the past few months he has been trying to go and not withholding but with not much luck. We have tried lactulose and more recently from the doctor Senna. I find the Senna gives him terrible stomach pain and he has cried himself to sleep tonight it's a viscous circle as I try to get him to eat more veg and fibre but when he is like this (hasn't been for a week) he can't eat or stomach anything his mood changes and he doesn't want to go to school. He has also become more clingy and have never had a problem with that before. The longest he hasn't been once was nearly 3 weeks. I'm at my wits end and also find its affecting /dictating our daily lives.

[Yael_Ro in reply to ClaraB1]

This is so hard. All of you must be in so much pain. I am far from an expert but did you try movicol and a lot of it? We have had some success with it but ours hasn't been withdrawing for so long.

Is your doctor good enough? Does s/he understand that huge impact it has on you all? Maybe you need to ask to see a specialist?

I hope that things will get a bit easier - I know how hard it is for everyone in the family.

Good luck

[ClaraB1]

Thankyou For your reply , I did suggest movicol as he was prescribed this when he was a baby as again suffered from constipation from a few months old up until a toddler , the doctor said that wouldn't work so prescribed the lactulose but it doesn't seem to have a quick enough effect. Did you find the movicol worked quicker? Eg a bowel movement daily/couple of days? I am going to go back to the doctors to push for a referral to hospital .

[Loutylegarw]

I second the book “what to do when you’re child won’t poo.” It’s great.

Movicol really is the best at getting on top of this, then adding a stimulant like picosulphate if you’ve reached maximum doses of movicol.

Movicol in increasing doses until the child can’t hold on to it and then maintaining and backing off on the dose really slowly, e.g by one sachet a week until they are doing one Bristol Stool Type 4 per day.

Reward just sitting on the toilet to start after a meal, even if it’s fully clothed and sitting on it with the lid still down. Using story books, or toys that are only available in the toilet. When those and sticker charts didn’t cut it any more we have resorted to putting child games/apps on an iPad and only allowing iPad use in the loo which is working a treat for us at the mo.